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APO LEADS Course Request

december, 2017

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APO LEADS COURSE REQUEST
Complete the form below to request an APO LEADS course to be presented to your chapter or event. Please note we require a minimum of 3 weeks’ notice to fulfill each request. When completing this form, select only one course per submission. If you are hosting a conference and would like additional courses, simply complete and submit a form for each course type. 
Note:  APO LEADS SERVE  is a weekend-long event schedule and coordinated by the National Office. Please see the APO LEADS Calendar for upcoming Serve events.. If your chapter/ section/region is interested in hosting an APO LEADS SERVE workshop, please contact the SERVE Coordinator to express interest. 

If you have questions regarding the status of your request, please contact the coordinator at [email protected] 

CONTACT INFORMATION
Full Namefirst & last name
Office Position/Titleif applicable
School Name
Section
EVENT DETAILS
NOTE: LAUNCH is a prerequisite to the other courses. Before scheduling an EXPLORE, ACHIEVE or DISCOVER Course you must determine if the attendees have taken LAUNCH.
# of Attendeesapproximate # expected
Conference Websiteif available
Presenter Namesonly list names if presenter has already confirmed availability
0 /
EVENT LOCATION
Location Name
Street Address
City, State, Zip
REQUEST DATES
Please enter your top three date/time choices for scheduling purposes.Providing multiple days will give our coordinators a better chance of finding a presenter.
Date Choice #1
Time Choice #1start time
Date Choice #2
Time Choice #2start time
Date Choice #3
Time Choice #3start time
EVENT AGREEMENT
Please read over the following requirements and enter your initials in the box below. By entering your initials into this box, you agree you have read and understood the requirements for hosting an APO LEADS Course.
  • I understand that by submitting this form I am agreeing to provide a room with seating for up to 30 people (and space for those 30 people to do exercises, in the case of the ACHIEVE).I also understand that if there are more than 30 attendees APO will locate more than one presenter which requires additional space to accommodate attendees in groups of 30 .

  • I understand that by submitting this form I am agreeing to provide the necessary supplies such as a whiteboard/chalkboard or easel/paper, an LCD or Data projector (depending on the course you selected above).

  • I understand that once my request has been approved by the appropriate Course Coordinator, I am responsible for promoting this presentation.
  • Electronic Signatureyour full name
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