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Educational Workshops & Training Form

Personal Information

Multi-line address
Birthday
Month
Day
Year

Educational and Employment Background

Workshop Interests and Goals

Learning Preferences

Barriers to Participation

Consent and Commitment

Consent to participate in workshops and training sessions
Consent
No Consent
Agreement to follow program guidelines and actively engage in sessions
Consent
No Consent
Commitment to complete any assigned activities or homework (if applicable)
Consent
No Consent

Follow-Up and Ongoing Support Preferences

Interest in follow-up sessions or additional training (if available)
Yes
No
Preferred method of communication for updates, reminders, and feedback

Feedback and Evaluation

Willingness to provide feedback on workshop experiences to help improve program quality
Yes
No
Interest in participating in future workshops or advanced training sessions
Yes
No
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