Foundations Tailored Training Request Form

Contact name:*
First Last
Name of organisation/community group:*
Address:*
Street Address Address Line 2 City State Postcode
Contact phone:*
Email:*
Enter Email Confirm Email
What has prompted you to request this training?*
What key learning outcomes or topics have been highlighted as high priority for your training?*
Has your organisation received LGBTIQA+ training previously?
Number of participants:*
Roles of participants:
Date for service requested - Preferred Option*
DD dash MM dash YYYY
*Please note that due to high demand for this training and availability the facilitator may be required to negotiate an alternative date
Start & Finish Time - Preferred Option*
Date for service requested - Second Option*
DD dash MM dash YYYY
Start & Finish Time - Second Option*
Training venue address
Street Address Address Line 2 City State Postcode

If you would like this training held at a venue outside of SHINE SA Woodville, please provide a training address. Please provide any further information regarding this venue such as IT set up, parking or sign-in/security requirements.
Any further comment
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