Professional Development & Training Inquiry Form
Thank you for your interestin Empower Freedom. We provide customized professional development, caregiver education, consultation, and coaching designed to support meaningful growth across home, school, work, and community settings. Please complete the information below. The more information you provide, the better we can tailor aproposal to meet your needs.
CONTACT INFORMATION
Organization/School/AgencyName
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Title/Role
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Primary Contact Name
*
Email
*
example@example.com
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Website
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AUDIENCE INFORMATION
Who is the primary audience for this training?
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Teachers
Paraprofessionals
Administrators
School Teams
Service Coordinators
Employment Supports Staff
Caregivers/Parents
Self-Advocates
Mixed Audience
Other
Approximately how many participants will attend?
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1-25
26-50
51-100
101-250
250+
What age group(s) will be discussed?
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Early Childhood
Elementary
Middle School
Transition Age
Adults
Across the Lifespan
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AUDIENCE INFORMATION
What type of support are you seeking?
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Professional Development
Parent/Caregiver Workshop
Conference Presentation
Keynote Presentation
Consultation
Coaching
Multi-Session Training Series
Other
Preferred Format
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In Person
Virtual
Hybrid
Open to Recommendations
Length of Training Requested
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60 Minutes
90 Minutes
2 Hours
Half Day (3 Hours)
Full Day (6 Hours)
Multiple Days
Unsure
How many sessions are you interested in?
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One Session
Two Sessions
Three Sessions
Four or More Sessions
Unsure
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TRAINING TOPICS
Please select all topics ofinterest.
Caregiver & Family Development
Creating Calm in the Chaos
Raising Emotionally Strong Children
Executive Functioning at Home
Building Independence in Everyday Life
Understanding School and Community Systems
Parent Empowerment and Advocacy
Supporting Family Well-Being and Reducing Burnout
Professional Development
Executive Functioning in Everyday Life
Emotional Regulation and Co-Regulation
Understanding the Why Behind Behavior
Communication and Connection
Creating Meaningful Visual Supports
Daily Living Skills and Independence
Teaching Life Skills Across Home, School, and Community
Building Independence Through Natural Supports
Person-Centered Planning
Career Exploration and Adult Readiness
Supporting Transitions Across the Lifespan
Home, School, and Community Collaboration
Building Inclusive Opportunities
Foundational Overview Topics
Understanding Sensory Differences and Practical Supports
Introduction to Autism and Neurodiversity
Trauma-Informed Perspectives
Motivation and Engagement Strategies
Customized Training
Customized Training Requested
Please describe the training topic you are interested in.
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What outcomes would you like participants to gain?
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Why is this topic important for your organization right now?
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CUSTOMIZATION QUESTIONS
What prompted you to seek training at this time?
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What are the biggest challenges your staff, team, or families are currently experiencing?
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What outcomes would you like participants to leave with?
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Are there specific situations, concerns, or examples you would like incorporated into the training?
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Have participants received similar training before?
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Yes
No
Unsure
If Yes, please explain.
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COACHING & FOLLOW-UPSUPPORT
Are you interested in follow-up support after the training?
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No
Yes
What type of support interests you?
Follow-Up Question & Answer Session
Individual Coaching
Team Coaching
Leadership Consultation
Classroom or Program Consultation
Ongoing Monthly Consultation
Ongoing Professional Development Partnership
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EVENT INFORMATION
Preferred Date(s)
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Preferred Time(s)
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Location (If In Person)
Will audio/visual equipment be available?
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Yes
No
Unsure
Will recording be requested?
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Yes
No
Would you like participant handouts or supporting resources included?
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Yes
No
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ADDITIONAL SERVICES & FUTURE OPPORTUNITIES
In addition to training,would you like information about:
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Additional Training Sessions
Consultation Services
Coaching Services
Resource Libraries and Materials
Licensing Opportunities
Train-the-Trainer Opportunities
Long-Term Professional Development Partnerships
Customized Resource Portal or Learning Hub
Not at This Time
Would you like a customized resource portal or learning hub for your staff, families, or organization?
Yes
No
Maybe, Tell Me More
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FINAL DETAILS
How did you hear about Empower Freedom?
Is there anything unique about your organization, audience, or community that would help us customize this experience?
Additional Questions or Information
Submit
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