Experience PD Where Learning is Lively

Please complete the following information about your upcoming event.

We look forward to making your Empowered RiseUp Workshop a success!

Personal Contact Information

First Name

Last Name

Email type

Phone Number

Your school or organization name

Preferred method of communication

Event Information Type "Don't know" if appropriate

Where will this workshop be held?

Empowered prefers tables and chairs rather than auditorium style seating for trainings.

City where workshop will occur

State where workshop will occur

Who is the intended audience for the workshop? (i.e. grade levels? subjects taught? administrators? etc.)

What month and day(s) do you plan on having your workshop?

What is your role in implementing the requested workshop?

If "Other", please describe

Estimated number of attendees?

What outcomes do you hope to achieve with your RiseUp Workshop?