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On-Site Training Request
This form will provide EC LEARN with the necessary information to meet your professional development on-site training request.
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* Indicates required question
Email
*
Your email
Name of Contact Person
*
Your answer
Phone Number
*
Your answer
Program Name
*
Your answer
Street Address of Program
*
Your answer
City and State
*
Your answer
County in which program is located
*
Boone
Bourbon
Campbell
Carroll
Gallatin
Grant
Harrison
Kenton
Owen
Nicholson
Pendleton
Scott
Other:
Type of training requested
*
In-Person (EC LEARN brings staff to your program to train participants)
Virtual (LIVE Webinar - Zoom)
Timeframe or Date(s) you are interested in offering training
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Your answer
Number of staff needing training
*
0 - 10 participants
11 - 20 participants
20 - 35 participants
35+ participants
Length of training
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1. 5 hour
2 hour
2.5 hour
3 hour
4 hour
5 hour
6 hour
Other:
I are interested in:
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a single training title/date
multiple training titles on the same date
multiple training titles on various dates
What are you specific training needs?
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Your answer
Topic choice (You are not limited to these topics, EC LEARN will work with you to meet your needs)
*
Assessment & Planning
Challenging Behaviors
CLASS
Developmental Milestones
Developmental Screening
Developmentally Appropriate Practices
Early Intervention
Early Literacy
Environmental Rating Scales
Family Wellness
Inquiry-Based Learning
Kentucky Early Learning Standards
Loose Parts
Social Emotional
Special Needs
Teamwork/Positive Culture
Work/Life Balance
Other:
Is there any other information you would like us to know?
Your answer
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