enCompass Instructor Application: Florida Spring Training

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

enCompass: A Comprehensive Training on Navigating Addiction

Name *

Organization *

Email *

Phone *

Organization Type *

Public

Not for Profit

Private

For Profit

Other

Industry Type *

Public Health

Faith Community

Corporate

Health System

Criminal Justice Agency

Higher Education

Primary/Secondary Education

Community-Based Organization

Required

Have you taken an enCompass training? *

Yes

Please share training and teaching experience. *

Why do you want to become an enCompass Instructor? *

Who will be your target audience/who do you plan to teach?
*

How will you/have you secured funding for manuals ($15 per person)?

Describe how you plan to build networks and expand the enCompass training to new audiences.

How many people will you train within the first year?

What are potential barriers to implementing enCompass?

Are you interested/available for the May 1-2 training in Ft. Myers, Florida? *

Yes

Do you require financial assistance? The cost of the 16-hour trainer certification is $2,300, not including travel costs and accommodations. *

Yes

Please share any other details about your interest in becoming an enCompass trainer.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Addiction Policy Forum. Report Abuse