A.C.E Organization Application

Main Information

Agency Name *

Required

Date *

Required

Agency Rep Name *

Required

Phone *

Required

Agency Rep Email *

Required

Event / Training Location

Event / Training Date

DD/MM/YYYY

Address

Country

Link to information about the training

Event/Training Website (if applicable)

Number of individuals to be trained?

Total cost of training?

$

Statement of Purpose

In the spaces provided below, please write a brief statement explaining your goals related to this particular event. Answer these two (2) questions.

1. What is it you hope to learn/achieve through this agency training? *

Required

2. How will you implement and ensure ongoing impact from the training for staff and community? *

Required