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Request A Training

Please fill out the form or contact Gloria Medina, Training Coordinator at gmedina@scopela.org.

Tell us about your organization:
* Organization Name
Street
City
State
Zip
Phone
Fax
Website
Who referred you to SCOPE?
Primary contact person for this training request:
* First Name
* Last Name
* Email
Phone
Alternate Phone
First Name
Last Name
Email
Phone
Alternate Phone
Organization Info
Which sector best describes your organization?
(check all that apply)
If this is a membership organization, tell us about your membership:
# of members
Do members pay dues?
What races/ethnicities are represented in your membership? (use percentages)
African-American
Middle-Eastern
Latino
Native American
Asian
White
Please describe your training request: (250 words or less, with no special formatting)
Training(s) that you are interested in:
Organizing:
Power analysis:
Civic participation:
Research:
Staff Development/Coordination and Technical Assistance
Who will be trained? (numbers)
Staff Members
Board Members
Community Members
Senior Staff
Others
Proposed dates of training (mm/dd/yyyy)
Proposed location of training:
Name
Address
City, State, Zip
Prefer to have the training at SCOPE
Need assistance identifying a location
Will you need translation?
If so, which languages and for how many?
How will your organization use what you learn in this training? (250 words or less, with no special formatting)
Please describe the geographic area that will be impacted by the work done as a result of this training. (250 words or less, with no special formatting)
First Name
* Required Field