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CLIENT SURVEY
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Organization
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Contact name
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First
Last
Phone Number
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Email
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Training/program
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Please select
Child Assault Safety Action (CASA) for Educators
Interludes of Conflict
The Culture of Violence in Schools
The Sticks and Stones of Bullying: What Everyone Should Know
Boys, Girls, & the Rest of Us: Understanding the Transgender Experience
The Dynamics of Diversity
LGBTQI Basics: A Look at New Trends in Public Education
The Poverty Puzzle
Special Education Basics
STEM in the Sticks: Engaging Rural Students in Science Education
Student Civil Rights in the Classroom
International Health and Development: The Importance of Culturally Competent Mental Health Solutions
Educator Code of Conduct (Ohio)
Undecided/Custom
Anticipated # of participants
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< 5
5 - 10
10 - 15
15 - 20
20 - 25
> 25
Desired length of training
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One hour
Half day
Full day
Multiple days
Cultural audit
Does management have an open door policy?
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Yes
No
Unsure
Not applicable
Is there a good stream of employee communications in the company?
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Yes
No
Unsure
Not applicable
Does the company have programs in place that demonstrate they value employee work?
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Yes
No
Unsure
Not applicable
Does the company invest in training to ensure employee success?
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Yes
No
Unsure
Not applicable
Our clients/customers are generally satisfied with our services.
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Yes
No
Unsure
Not applicable
Please list any specific topics that should be covered in our training.
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Have there been any events/incidents/disturbances at your organization relevant to this training? If so, please describe (excluding names and identifying characteristics of those involved).
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