Number of people attending Take-Out:
Preferred date of Take-Out: **Please note that LEAD Team & Leadership Development require a minimum of two weeks to prepare for a Take-Out
Preferred time of Workshop:
Preferred length of Take-Out:
Please specify "Other" length:
Preferred location of workshop:
Topic(s) of interest (Select all that apply):
Please specify "Other" topic:
Please describe a couple of learning outcomes for participants. Describe what you want participants to get out of this Take-Out:
Describe how knowledgeable the participants may already be regarding the topic(s) selected:
What is prompting your request for Leadership Take-Out? How will this workshop benefit your group?
Do you have any questions? Is there any additional information you would like the facilitators to know?
Please do not hesitate to contact firstname.lastname@example.org with any additional information or questions after you submit this form. Thank you!