Request for Training of Early Childhood Education Providers 1. Please provide us with the following information. Enter "N/A" in boxes that do not apply.Name* First Last Role*District/Community*Phone*Email* 2. Please indicate the training topic you are interested in:Choose all that apply. Creating a classroom for diverse learners Strengthening the social and emotional development of all children Implementing strategies for engaging hard to reach families Collaborating with your paraprofessional to meet the needs of all children in the classroom Improving the early identification of children with Autism and other developmental disabilities Additional topics?3. Purpose of training:Type or copy and paste text.4. Please indicate the following:Possible Dates:Preferred Time of Day:Duration: (# hours or days)Location:Anticipated Number of Attendees:Primary Role of Attendees:Primary Age Group Served:5. What is the plan for sustainability following the training?Type or copy and paste text.6. What further resources might you need?Type or copy and paste text.7. What role will the administrator (Principal, Director, Supervisor) have in the training and sustainability plan?Type or copy and paste text.8. Equipment available onsite for training:Choose all that apply. Overhead Projector TV/VCR Projector Overhead Screen Laptop Please specify other required equipment.