Site Specific Request Form 25-26
All requests are subject to trainer availability. There must be at least 5 participants in attendance. All requests will be in person. Requests must be submitted at least a week before requested date of training.
Center Name
*
Contact Person
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Preferred Date and Start Time of Training
Number of Hours Needed
*
Training Title Requested
*
List Number of Attendees
*
Trainer Requested
*
Eve Talley
Allison Talley
Dana Comeaux
Lacy Devillier
Shaunda Guidroz
Jacqueline Richard
Jill Levine
Denise Durbin
Tracy Flynn
Shatari Hunt
Elizabeth Bakies
Ree Smith
Courtney Vincent
Other
Reason For Requesting Training
*
Site Improvement
Area of Improvement Needed
Not Offered on the Calendar
Sessions on Calendar are Full
Other
New Center
Which Dimension Did Your Center Score Lowest in CLASS Infant
*
Relational Climate
Teacher Sensitivity
Facilitated Exploration
Early Language Support
My center does not have infants
My center is new and has not been observed
Which Dimension Did Your Center Score Lowest in CLASS Toddler
*
Positive Climate
Negative Climate
Teacher Sensitivity
Regard for Child Perspectives
Behavior Guidance
Facilitation of Learning and Development
Quality of Feedback
Language Modeling
My center does not have toddlers
My center is new and has not been observed
Which Dimension Did Your Center Score Lowest in CLASS PREK
*
Positive Climate
Negative Climate
Teacher Sensitivity
Regard for Student Perspectives
Behavior Management
Productivity
Instructional Learning Formats
Concept Development
Quality of Feedback
Language Modeling
My center does not have Pre K
My center is new and has not been observed
Any Other Information?
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Facility Information
Please provide information about your facility below.
We strongly encourage centers to allow participants from other centers to register for classes being held at their center, in order to ensure everyone has the opportunity to participate and get the clock hours needed. Are you willing to open your center to other providers?
Yes
No
Please check all items that your facility has available.
Wi-fi
Adult table and chairs
Smart Board
Wall suitable for projecting
Number of adults my center can seat comfortably.
I understand that there must be at least 5 participants (type III or FHP) in attendance for the training to take place.
Yes
No
I understand that the training is not scheduled until I receive the registration link to register my staff for the trainings. I also, understand that is my responsibility to register my staff within three days of receiving the registration links.
Yes
No
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