Request to host a Training Course


Agency Name:
Which course(s) are you interested in hosting?	Advanced Dispatcher Update Course 1 day Advanced Dispatcher Update Course 2 days Advanced Dispatcher Update Course 3 days Basic Critical Incident Stress Management (CISM) course (2 days) Intermediate CISM (2 days) Advanced CISM - Train the Trainer (2 days) Post-Trauma Stress for Managers (3 days) Death/Trauma Notification (1 day) Stress Management for Tactical Dispatchers (1 day) Dealing with Suicidal Callers (1 day) Dealing with Suicidal Subjects (1 day) Beyond Stress Management-Building Meaning in your Life (1-2 days) Managing Cumulative and Critical Incident Stress (1 day) Dispatcher Supervisory Update (3 Day)
Proposed Course Dates:
Preferred Course Hours:	0800-1700 1000-1900 1200-2100
Official Name of Agency:
Agency Address:
Course Location Name & Address:
Name of Contact Person:
Phone Number:
Email Address:
Course location information:
Room seats 30 - 35 students and has tables and chairs conducive to sitting for 8 hours?	Yes No
Room has white board and PowerPoint projector available?	Yes No
Any parking issues?	Yes No
Can provide light refreshments? (ie: coffee, water, bagels, fruit)	Yes No
If possible please provide the names of recommended hotels:
Comments / Questions: