GUW Training Report

GUW Training Report Form

* Indicates required field

Facilitator Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

Co-Facilitator Name *

First

Last

Co-Facilitator Name *

First

Last

Co-Facilitator Name *

First

Last

Date(s) Held *

Location *

Training Time *

Combination Training with PLT? *

Yes No

Open to General Public or Closed to Specific Group (ROE/In-Service, etc.) *

Number of Participants *

Number of Guides Received *

Number of Guides Used *

Number of Guides Returned *

$ Amount to be invoiced (# Guides @ $24 each) *

$ Additional Funds received you wish to contribute to EEAI: *

Please provide a breakdown of participant backgrounds (Formal/Non-formal/Pre-service/Daycare, etc.): *

List any in-kind donations/grants/scholarships obtained for this training: *

Did you use any of the resources provided by state coordinator (PowerPoint, Certificate/flyer templates, EEAI brochures, Evaluations, etc.)? *

Please list any updates or suggestions for future resources that could help you in your facilitation: *