Request a training at your Workplace - MHSS - Centre for Culture, Ethnicity & Health

Contact Details

Organisation*

Address*

Street adress Street adress line 2 Suburb State Post code Country

Contact name*

First Last

Contact number*

Email*

Enter email Confirm email

Purpose/reason for the training day*

Specific learning objectives

Who is the training for (target group)*

Number of participants*

Please enter a value greater than or equal to 0.

Proposed date of training (booking needs to be made four weeks in advance)*

Proposed time of training*

: HH

MM

Address of where the training will be delivered*

Same as organisation address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Which of the below equipments are available?*

Please select all that is available

Any additional information?

Do you wish to receive updates and information about CEH?*

Do you agree to be contacted by CEH within 6 months of the training session to participate in further evaluation of the session(s)?*

Name

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