Name

Email Address

Phone Number

Name of Organization

Address of Organization

What are learning goals of the training?

Have the staff or organization had any training in Anti-Oppression/Anti-Racism, and /or 2SLGBTQ+ training? Have the staff or organization had any training in Anti-Oppression/Anti-Racism, and /or 2SLGBTQ+ training? yes no

If yes, please describe briefly when the training was, and were the learning goals achieved and /or sustained?

Who is attending the training? Please provide the estimate number of attendees.

Is this training for : Is this training for : Lunch and Learn half day (3.5 hours (half –day) 7.5 hours (full-day)

The ideal date (s) (month, day and time) for the training.

Address of training if different from the organization.