Company Request form for Community Education

Request form for Community Education

Thank you for your interest in partnering with RISE Community Solutions for your training and educational needs.

Please complete the brief form below to provide information about your organization and the training services you are seeking.

A member of our team will review your request and contact you
shortly to discuss next steps. We appreciate the opportunity to work with your organization and look forward to connecting with you.

Name

First NameLast Name

Company and Title

CompnayTitle

Email

Phone Number

Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Which training are you interested in?

Youth Mental Health First Aid Training is a 7.5-hour training; do you prefer full-day or (2) half-days?

Other

Preferred Training Dates

Preferred Schedule (Standard 9am-4:30pm or choose a block between 9am to 8:30pm)

Estimated Number of Participants

What is the primary language of the group?

Other

Will you be providing a venue (meeting space) for this event?

Other

Audience Type

Parking

Other

Food & Beverage (F&B)

Available On-Site (Check all that apply)

Picture of your meeting space if available

Room must have enough space for people to comfortably move around and do break-out activities.

Please let us know if your group requires any special accommodations such as ASL interpretations, physical accessibility, language translation, or other.

Please share with us why you're interested in this training and what you hope to gain from it.

Please check that the contact information you provided is accurate and we will reach out to you ASAP to discuss training options for you and your organization.

In the meantime, please feel free to reach out to:

Trinity Kimble, Director of Community Education:
Trinity.Kimble@RISEcs.org

Courtney Joy, Community Education Support Coordinator: Courtney.Joy@RISEcs.org

Thank you!