Loading....

Thank you so much for your interest in doing a training with MHALC! Please fill out the brief form below so that we can get a better idea of what your organization is looking for and we'll reach out to you shortly.

*Please note, MHALC requests that all trainings be at least two weeks after the request is submitted to give proper time for the trainer to prepare.

Organization Name*

First Name*

Last Name*

Work Phone*

Email Address*

Please List the Location of the Training

Address, line 1*

City*

State*

Zip Code*

Billing Name (Organization or Contact)*

Billing Email, if different

Billing Phone Number, if different

Billing Address, Line 1*

Billing City*

Billing Zip Code*

Estimated Number of Attendees*

Anything specific we should know about the audience?

Is there a specific date and time for the requested training*

Yes No

If Yes:

ex. 7/10/23 10:30 am

Date Request

If No:

ex. fall 2023; October 10^th - 20th; etc

Date Range for Training*

Do you have a specific topic or theme for this training?*

*Learn more about our trainings by visiting our website HERE

If you answered Other above,

Please provide us with a short paragraph detailing what type of training or what training content you would like covered

Describe Your Training

Is Your Organization a Registered Nonprofit?*

Yes No

We will never share your email address. Ever.

ORGANIZATION NAME
ORG ADDRESS LINE 1 ORG ADDRESS LINE 2
ORG CITY, ORG STATE ORG ZIP
ORG CONTACT PHONE
ORG CONTACT EMAIL

Checkout

Sorry, we're not targeting any representatives in your district. But, you can still help!