PPTA Host Site Interest
Thank you for your interest in support a PPTA event or training
Agency Name
*
Agency Address (Event Location)
*
Street Address
Street Address Line 2
City
State
Zip Code
Name of Primary On-Site Coordinator
*
First Name
Last Name
Title
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Max Capacity (classroom style):
*
Max Capacity (board/roundtable style):
*
Does Your Agency Require On-Site Support from PPTA Staff? (Please note: PPTA will handle all planning logistics)
*
Yes
No
Unsure
Can your agency support hands-on workshops (maintenance/mechanic-style)?
*
Yes
No
Unsure
AV/Tech Available (check all that apply):
*
Projector or Large Display
Screen
Speakers/Microphone
Wi-Fi for Presenters
Wi-Fi for Guests
Whiteboard or Flip Chart
Can Support Hybrid Events
Parking:
*
Free On-Site
Free Nearby
Paid Nearby
Other
Optional -- Preferred Catering/Food Vendor:
Submit
Should be Empty: