C.A.E. Workshop Request Form

C.A.E. Workshop Request Form

Please complete form in its entirety to better serve your desired needs. A C.A.E. team ambassador will contact you within 24 hours.
CONTACT NAME*

PrefixFirst NameLast NameTitle
INSTITUTION NAME*
SERVICE LOCATION*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Format: (000) 000-0000.
Email*
example@example.com
WEBSITE*
www.websitename.com
DESCRIBE DESIRED OBJECTIVES*
What are your desired outcomes?
WHAT IS YOUR BUDGET?*
50% of Budget due at the signing of the contract
GRADE OF STUDENTS*

Grades 1-2Grades 3-4Grades 5-6Grades 7-8Grades 9-10Grades 11-12
ESTIMATED # OF STUDENTS*
TYPE OF WORKSHOP*

After SchoolIn-SchoolSummer CampOther
ANTICIPATED START DATE*

MonthDayYear
Date
ANTICIPATED END DATE*

MonthDayYear
Date
INSTRUCTION DAYS*

MondayTuesdayWednesdayThursdayFridaySaturday
ANTICIPATED START TIME*

Hour Minutes

AM/PM Option
ANTICIPATED END TIME*

Hour Minutes

AM/PM Option
MODULES OF INTEREST*
Should be Empty: