Corporate/In-house Training Request Form

INHOUSE EMPLOYEE TRAINING INFORMATION REQUEST
Contact Name:
Position:
Company/Organisation:
Company/Organisation Website address:
Email:
Telephone Number:
(including area code - direct number please)

Fax Number:
(including area code)

Mobile Number:

Training topic :

Required training description :

Participant numbers and background :

Reason for interest in the course/s:

Expectations of the course/s:

Other relevant factors:


Expected timing of the training (if possible list required dates):


Do you have a training venue suitable for a small group?

Yes No

If yes, please list venue address (to be confirmed):


You will receive an acknowledgement email within a few minutes of sending your request. If you don't, please use the email alternative below. Thanks.

Derek Stockley has an Email Newsletter. If you are not a subscriber, would you like to be included on the mailing list?

Yes No

When you press the "Register now" button, you may be advised that your email address is being transmitted, and the data is not encrypted - please press "OK".



For your record, a copy of this email will be placed in your "sent" folder.