PTP's Program: Training - Inquiry Form

Interested in learning more about PTP's technology training programs for Community Organizers? If so, we'd like to hear from you. Please complete the form below and we'll contact you within one business day.

Salutation:	--None-- Mr. Ms. Mrs. Dr. Prof.
First Name:
Last Name:
Title:
Organization:
Email:
Phone:
Fax:
Cell Phone:
Address:
City, State, Zip:	Zip: Country:
Web Site:
Which trainings are you interested in (TechCamp, COATI, Basic Voter Data Skills)?:
What organizations are interested in receiving training?	--None-- My organization A regional cluster of allied organizations A network of organizations that my organization is part of
Number of Staff:
Legal Name of 501C(3) organization or fiscal sponsor:
What issues do you organize around? Select all that apply.	Anti-Racism Civic Participation Civil and Human Rights Corporate Accountability Disability Rights Economic Development Economic Justice Education / Child Care Environment Environmental Justice Government Accountability Health/Health Care Immigrant Rights Land Use Media Accountability Multi-Issue Community Organizing Native Rights/Sovereignty Neighborhood Revitalization Police Accountability/Prison Issues Progressive Media, Arts and Culture Racial Justice Sustainable agriculture TANF or Welfare Rights Tax Policy Trade policy Transportation Violence Prevention Voting Rights Women's Empowerment Women’s Reproductive Health Workers’ Rights Youth Empowerment Other None (For multiple selections, hold CTRL (windows) or Apple (mac) key while clicking)
Who do you organize? Select all that apply.:	Workfare workers / TANF recipients Low-income Moderate-income Low-wage workers Injured workers Disabled Homeless Unemployed Tenants Incarcerated or formerly Incarcerated Immigrants/Refugees Women Veterans Farmers/Ranchers LGBTIQ Youth Seniors Arab and Middle Eastern Asian / Pacific Islander African American African Latino or Caribbean Native American/Indigenous White People of Color Urban communities Rural communities Everyone (For multiple selections, hold CTRL (windows) or Apple (mac) key while clicking)
Who makes up your organization?	Individuals Organizations No Membership none of the above (For multiple selections, hold CTRL (windows) or Apple (mac) key while clicking)
Who leads your organization?	--None-- Members Elect Board Board Elects Board Volunteer Board none of the above
What type of organization do you work for? :	--None-- Local Grassroots Organizing Group State-wide or Regional Grassroots Organizing Group National Grassroots Organizing Group Service Provider Coalition Advocacy Organization Consultant to Non Profits Technical Assistance Provider Think Tank or Research Group Union Foundation Other
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