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WI CHW Training Submission Form
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* Indicates required question
Title of Training/ Professional Development Opportunity
*
Your answer
Contact Information for Person Submitting Form (this information will not be made public, only collected for questions from the curriculum and training committee)
*
Your answer
Resource Link
*
Your answer
What is the cost?
*
Your answer
Date(s) of Training
MM
/
DD
/
YYYY
Time of Training
*
Time
:
AM
PM
Is there a certificate of completion offered?
*
No
Continuing Education Units (CEUs)
Certificate Offered
Required
Notes
Your answer
Location of Training
*
Virtual
Hybrid
In person (if in person, please type the location in the next question)
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