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Getting Ahead Facilitator Training
Please complete this form if you are interested in the Facilitator Training. Questions? Contact Bonnie Bazata at 520-724.3704 or
bonnie.Bazata@pima.gov
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Email
*
Your email
First name
*
Your answer
Last name
*
Your answer
Contact phone #1
*
Your answer
Contact phone #2
Your answer
Mailing Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Organizational Affiliation (if applicable)
Your answer
Title
Your answer
Are you a Getting Ahead Graduate?
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Yes
No
If yes, where and date
Your answer
Have you taken the Understanding Poverty Workshop?
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Yes
No
Not sure
If yes, where and date
Your answer
Do you have any dietary restrictions?
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Yes
No
If yes, what are they?
Your answer
What is the best day of the week to attend a workshop? (Mark all that apply)
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Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Doesn't matter
Required
Do you have a site where you'd like to be a Getting Ahead co-facilitator or facilitator?
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Yes
No
Not sure
If yes, where?
Your answer
What is the most important goal for you in taking this workshop?
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Your answer
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