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* 1. Agency Name:

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* 2. Contact Name:

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* 3. Title:

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* 4. Address:

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* 5. Email:

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* 6. Phone #:

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* 7. Requested Training Date & Time:

Thank you for inquiring about our Cultural Awareness and/or Historical and Intergenerational Training. Please answer the following questions so we may tailor the training to your Agency’s needs.

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* 8. Which training are you requesting:

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* 9. What is the duration of time requested? (Please note that we do NOT recommend anything less than 1 hour)

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* 10. What services does your agency provide and who do you serve?

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* 11. Who is the audience participating in the training session?

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* 12. How many participants are you expecting to attend?

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* 13. Do you prefer an in-person or virtual training? If in-person, where will the training take place (include address and contact number if different from above)?

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* 14. If you prefer a virtual training, please indicate the platform you would prefer:

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* 15. On a scale from 1 (no knowledge) to 10 (expert), how would you rate the participants’ level of knowledge of American Indian Culture?

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* 16. What outcomes do you want your participants to realize through the training?

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* 17. Are there specific topics that you want to have addressed in the training?

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* 18. Will a certificate of participation be needed?

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* 19. Will you be able to provide a projector, internet access and, if needed, a microphone?

We request that a donation be made to the Phoenix Indian Center for the Cultural Awareness and/or Historical and Inter-generational Trauma Workshops. If you would like a specialized training, please contact LanguageCulture@phxindcenter.org or egoodsoldier@phxindcenter.org to discuss costs.

For more information, you may contact:

Elicia Goodsoldier, Language and Culture Program Manager
egoodsoldier@phxindcenter.org or LanguageCulture@phxindcenter.org
Phoenix Indian Center
(602) 264-6768 ext. 118

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