Name *

First Name

Last Name

Phone

(###)

###

####

First Choice of Date: *

MM

DD

YYYY

How many sessions are you seeking to fill, and please indicate how long for each? *

Please check all that apply:

1 Session

2 Sessions

3 or more Sessions

45 minutes each

60 minutes each

90 minutes or longer

Other: Please explain in last question.

Who is the target audience? *

Please check all that apply- we can designate audiences to a specific session when booking if more than one session:

Child Care Leadership Teams

Child Care Teachers

Child Care Owners

Non-childcare audience

Other

Which training topics are you most interested in? (not limited to just this list) *

Conflict Resolution

Communication

Crisis Management

Leadership Team-Building or Skill-Building

Child Care Advocacy Education and Training

Mental Health Topics, including ADHD & Personality Conflicts

Other