Trainer Needs Request Form
Trainer Information
Name*     
Address (if new)  
 
Phone (if new)  
 
E-mail*  
 
 
Workshop Information
Title of Workshop*    

Location of Workshop  
 


Dates of Workshop  
 


Will you need lodging?  
   
   
 
If needed, dates of lodging   
  
Equipment   Needs
   
   
   
   
   
   
 
  VCR/TV Dates Needed  

 

  LCD Projector Dates Needed

 

  Laptop Dates Needed

 

  Flip Charts - How many?

 

  Podium Dates Needed    
  
 

 

 

 

 

 

 

 

     
  
Other Equipment Needed     
 Dates
Room Setup  
 
   
   
   
 
Handouts
Handout Preferences  
   
   
   
   
 
Handout Organization  
   
   
   
   
 
Special Handout Distribution  
 
Any other requests?