Name
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First
Last
Email
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Phone
Agency/Organization
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Which MOD training are you interested in?
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ADA Title I: Employment
ADA Title II: State and Local Governments
ADA Title III: Public Accommodations (businesses open to the public)
Please briefly describe the topics you'd like covered or questions you'd like answered:
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When would you like to hold the training?
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If unknown, please write an approximate time frame or "flexible"
MOD is currently holding our trainings virtually unless there is a need for in-person attendance. Please select one:
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A virtual training will work for our group
Our group requires an in-person training
Unsure
Estimated number of attendees:
How did you hear about MOD?
Email from MOD
MOD website
Internet search
Social media
At another MOD training or event
Additional comments: