Thank you for your interest in a training from the Northwest ADA Center. To help us track and respond to your request as soon as possible, please complete the following form, which asks for details about your training needs and preferences. First Name * Last Name * Position Agency/Organization * Email * Phone * Cell Phone * Topic(s) (check all that apply) * Americans with Disabilities Act (General) Accessible Parking Assistive Technology ADA Title II (State and Local Government) ADA Title III (Public Accommodations) Disability Language and Etiquette Effective Communication Education Emergency Preparedness Employment (ADA Title I) Healthcare Hospitality Housing Legal Resources Reasonable Accommodations Service Animals Telecommunications (ADA Title IV) Transportation Veterans Other Requested start date if known Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year202220232024 Requested end date if known Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year202220232024 Location of Training/Event (please be as specific as possible) * Type of Event * - Select - In-Person Presentation Webinar Presentation Video Webinar Presentation Train-the-Trainer: How to Do a Site Survey Teleconference Presentation Conference Presentation Conference/Event Vendor Length of Training/Event Do you have a budget for this project? * Yes No Not sure Estimated Size of Audience Audience Make Up (all that apply) Continuing Education Credits/Letters of Attendance * CRCC Credits ACVREP Credits Letters of Attendance None Reasonable Accommodation Requests (please write "N/A if no accommodations are needed) * Other Comments/Questions One of our staff members will contact you shortly about your request. Thank you again! Leave this field blank
