Oglala Lakota College - Agriculture & Natural Resource Department

Workshop Request Form

* = Required information
Client Information		Workshop Location (if different)
*Your name		Location name
*Your title		Location title
*Organization		Location organization
*Address1		Location address1
Address2		Location address2
*City		Location city
*State		Location state
*Zip code		Location zip code
*Phone		Location phone
*Fax
*E-mail
Workshop Type (submit one form for each type)
*Training		If “other”, specify
*Format		If “other”, specify
*Preferred date		Second alternative date
*Alternative date		Third alternative date
maximum number of participants = 40
Workshop Participants by Grade Level
High School		College
*Freshman		*Freshman
*Sophomore		*Sophomore
*Junior		*Junior
*Senior		*Senior
*Reading Specialists		*Other (specify titles)
enter zero if not applicable
General Information
*How did you hear about us?		Do you care to join our mail list? (e-mail & print)
Comments

We respect your privacy and do not give our contact names to anyone. You may review our privacy policy posted elsewhere on this site. Please note above if you would like to receive future mailings and offers about our programs and services.

Press Submit to send your workshop request.
Submit one form per workshop.

Press Clear to erase all above information and re-enter.

If you experience any problems with this form, please send an e-mail to Randy Two Crow.

Kids Page