Workshop Request Form

If you are human, leave this field blank.

Workshop Request Form

Please use this form to request a professional development workshop or presentation by members of the Pacific Leadership Assistance Network (PLAN).

Contact Person's Full Name *

Email *

Phone *

Organization Name *

Website URL (if any)

Cut and paste the URL of your organization website or Facebook page. It should start with "http://" or "https://"

Organization Type *

College / University

K-12 School

NGO

Business

Club / Association

Government Agency

Office / Center

Event Type *

Staff Development Day

Annual Conference

One Off Event

Please tell us if the requested workshop is part of a larger professional development initiative.

Your Role *

Director / CEO / President

Program Coordinator

Member

Other

About your organization *

Please provide a short paragraph description about your organization's mission that we can use on our website to honor and celebrate your contribution to the lives of Pacific Islanders. Feel free to cut and paste it from your existing documents or website.

Statement of Need *

Please kindly describe the current situation at your organization including an estimated number of COFA citizens you serve, successful practices you've implemented to support their needs, and the kind of professional development workshop(s) you are requesting from PLAN.

Spotlighting Your Organization? *

Yes

No

We are starting a new initiative to honor, celebrate, and bring attention to the work of organizations, agencies, businesses, clubs / associations that aim to serve the wellbeing of Pacific Islanders particularly from the Micronesian region of the Federated States of Micronesia (FSM), Republic of Palau, and the Republic of the Marshall Islands (RMI) living at home and abroad.

Submit