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CPI Training Request in Your District
Please complete this form if you are requesting in-district CPI Training where a CPI Trainer comes to your
school district
to train 5-30 people. To see pricing and criteria, please see the image below.
You will hear back from Megan Shook once you complete this form. If you feel the need to follow up, please email
shook.megan@moesc.net
.
If you are an individual wanting to attend a CPI Training already scheduled at MOESC, please register here:
Mid-Ohio Educational Service Center - Event Registration (moesc.net)
Trainings are listed on our website:
Mid-Ohio Educational Service Center (moesc.net)
.
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* Indicates required question
Email
*
Your email
CPI In-District Cost and Criteria
School District
*
Your answer
Contact Name
*
Your answer
Contact Email
*
Your answer
Contact Phone
*
Your answer
Type of Training(s) Requested
*
Please select all that apply.
CPI Initial (8 hours)
CPI Refresher (4 hours)
CPI Autism (8 hours)
Required
Preferred dates and times you are requesting for training.
*
Please provide a few options in order of your preference.
Your answer
Location of training
*
(i.e. specific building and room at your district, local conference center room, etc.)
Your answer
Estimated Participants for CPI INITIAL Training. (Please enter "no" if you are not requesting.)
*
30 maximum for an Initial class
Your answer
Estimated Participants for CPI REFRESHER Training. (Please enter "no" if you are not requesting.)
*
40 maximum for a Refresher course
Your answer
Estimated Participants for CPI AUTISM Training. (Please enter "no" if you are not requesting this.)
*
Your answer
Will you provide a sign in sheet for our speaker and make a copy?
*
Yes
No
Please be sure you provide AV support for our instructor and enough space for participants to practice safety interventions.
*
No problem!
Other:
Feel free to offer a recommended area of focus and/or share particular challenges so the presenter can better meet your needs.
Your answer
Other notes/comments you'd like us to know.
Your answer
A copy of your responses will be emailed to the address you provided.
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