Training Request Form Fill out this form to request a training or consultation from the Washburn Training Institute. Question Title * 1. Contact Information Name Organization City State Email Address Phone Number Question Title * 2. How did you hear about us? Attended a previous training hosted by the Washburn Training Institute Website (washburn.org or washburntraininginstitute.org) Training Institute mailing list Referral Other (please specify) Question Title * 3. Training Topic Child Development Developmental Repair PracticeWise TF-CBT Therapeutic Language Other (please specify) Question Title * 4. Training Information Desired length of training Date preference Time preference (if known) Anticipated # participants Please describe the audience Desired trainer (if no preference, please leave blank) Training LocationThe United Health Foundation Training Institute at Washburn Center for Children is located in Minneapolis, Minnesota at 1100 Glenwood Avenue. Our training facility can accommodate up to 140 people. Question Title * 5. Are you interested in having Washburn host your training? Yes No If no, please specify where you would like the training to be held: For training and consultation rates, please contact traininginstitute@washburn.org Done
