Request Form | BR Collins

First name

Last name

Title

Agency / Organization Name

Agency/Billing Address

Preferred Training Date

Is your date flexible?

Yes

Alternative Dates

If you selected “Yes” above, please provide alternative dates here.

What type of training are you interested in?

Expected Number of Participants

An estimate is fine.

Training Location Name

Training Location Address

(Address, City, State Zip)

Tell us a little about your goals for this training.

Example: board onboarding, leadership development, communication improvement, governance alignment, etc.

Are there any specific topics you would like Bobby to emphasize?

How did you hear about B.R. Collins Training Group?

I understand this form is a request only and my date is not confirmed until I receive a contract from B.R. Collins Training Group.