Office of Domestic Violence & Sex Offender Management
Specialized Trainer Application
This form is intended for individuals who are experienced trainers and possess expertise in specialized areas that are relevant to the domestic violence and sex offense management fields. The Office of Domestic Violence and Sex Offender Management (ODVSOM) is assembling a catalogue of possible training resources that can be offered annually to stakeholders for training credit and professional development. Examples of some specific and specialized trainings include, but are not limited to, risk assessment, female offenders, LGBT+ offenders, psychopathy, etc. Submission of this form does not guarantee any contractual agreement with the ODVSOM. Rather, if selected, the ODVSOM may consider and choose to advertise training events based on interest, registration, cost, and availability. If you are interested and would like to be considered as part of a training catalogue, please complete this form.
Name
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First Name
Last Name
Organization:
Position:
Degree:
*
Credentials:
*
Business Address:
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Title of Presentation:
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Topic
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Population Covering:
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Please Select
Domestic Violence Management (DV)
Sex Offender Management (SO)
Crossover (DV & SO)
Level:
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Please Select
Beginner
Intermediate
Advanced
Targeted Audience:
*
Please Select
Adult
Juvenile
Both (Adult & Juvenile)
Format:
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Please Select
Online
In-Person
Hybrid
Abstract:
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List 3 Objectives of Presentation (Objectives should describe what the learner will be able todo at the end of the presentation.)
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Allow presentation to be recorded & broadcasted on demand?
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Yes
No
AV Requirements:
Laptop
Clicker
Flip Chart
Markers
Other
Training Duration
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Training Fee:
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Preferred training class size:
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Does your training include cultural sensitivity/application information?
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Yes
No
On a scale from 1 to 5, with 5 being most comfortable, rate your presentation skills in-person:
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1
2
3
4
5
On a scale from 1 to 5, with 5 being most comfortable, rate your presentation skills via an online platform:
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1
2
3
4
5
On a scale from 1 to 5, with 5 being most comfortable, rate your facilitation skills in-person:
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1
2
3
4
5
On a scale from 1 to 5, with 5 being most comfortable, rate your facilitation skills via an online platform:
*
1
2
3
4
5
Are you seeking to improve on your presentation and facilitation skills
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Yes
No
Are you willing to be a mentor to someone seeking to improve on their presentation and facilitation skills?
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Yes
No
Biography for the Trainer:
*
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Curriculum Vitae:
*
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Resume:
*
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Submit
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