Powerful Tools for Caregivers - Class Leader Training

Powerful Tools for Caregivers - Class Leader Training - Confirmation Form

Thank you for planning to offer the Powerful Tools for Caregivers Class Leader Training. Please complete this form to register your event. After your submission, we will contact you with more details.

Step One: Contact Information for Master Trainers

Thank you for co-leading a class leader training. Please provide information about the Master Trainers who are facilitating the Powerful Tools for Caregiver Class Leader Training. This contact information will not be shared with the event unless it is the registration information.

#1 Master Trainer's First Name*

#1 Master Trainer's Last Name*

#1 Master Trainer's Email Address*

#2 Master Trainer's First Name*

#2 Master Trainer's Last Name*

#2 Master Trainer's Email Address*

#3 Master Trainer's First Name

#3 Master Trainer's Last Name

#3 Master Trainer's Email Address

Step Two: Class Leader Training Event Details

Now that you've told us who you are, we need the details of your class leader training.

What is the format of this PTC Class Leader Training event?*

In-Person

Virtual

Which platform will the virtual class series use?

Select

CLT: Begin Date*

Reminder:

Virtual trainings should run five consecutive days.

In-person trainings should be two consecutive days.

CLT: End Date*

What time is the Class Leader Training?*

e.g. 9:00am - 12:00pm

Time Zone*

Select or enter value

What is the cost of this training for each trainee?*

Remember, the Class Leader license fee due to Iowa State University is $200 per trainee.

Host Organization*

Name of the organization sponsoring or supporting the Class Leader Training

City where Class Leader Training is offered:*

State/Providence/Country where the class leader training is offered*

If this is a virtual training, list the state the #1 master trainer is located.

Select

Would you like this class leader training event added to the PTC website?*

If the training is a private event, remember we can still post the training the PTC website with a restriction listed (e.g., open only to Residents of Wisconsin).

Yes, please

No, thank you

Is this a public or private event?*

Select or enter value

To which group is this class leader training restricted to?

Website link AND/OR Host/Sponsor Organization:

Paste a weblink where registrants to find other details for the Class Leader Training.

Use this space to tell us the name of the host or sponsor organization. If this class series is posted on the PTC website, we will list this name as the sponsor organization.

Event Contact Information

Registration Name*

Whose name should be shared alongside the registration email?

Registration Email Address*

Which email should new class leaders use to register for the event?

Registration Phone Number

Phone

Event/Volunteer Coordinator Information

Would you like an event/volunteer coordinator to be included in the communication about this class series?*

Yes

Event/Volunteer Coordinator Name

Event/Volunteer Coordinator Email

Class Leader Training Policies

1. All content and activities from the PTC Class Leader Training Script must be completed. 2. Master Trainers must pay the Class Leader License Fees to Iowa State University Extension Store no later than 10 days after the start date of the Training. 3. The roster email task must be completed within 7 days after the date of the first class. 4. PTC Trainers are ultimately responsible for overseeing all class leader training activities and ensuring that the standards and procedures of the PTC program are maintained.

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