Trainer Interest Questionnaire

Register

            Trainer Interest
                
Thank you for your interest in becoming a Be Active Kids trainer! We'd really appreciate you taking a few minutes to complete and submit the short questionnaire below to ensure that you have the potential to be a successful trainer.

                            First Name
                            		This field contains the user's first name.
                            
                            *
                            
                            Last Name
                            		This field contains the user's last name.
                            
                            *
                            
                            Organization
                            		
                            *
                            
                            Job Title 
                            		
                            *
                            
                            County
                            		
                            *
                            
                            City
                            		
                            *
                            
                            Phone Number
                            		
                            *
                            
                            Email
                            		A basic email field for collecting stuff like an email address.
                            
                            *
                            
                            What do you hope to do/accomplish as a Be Active Kids Trainer? 
                            		
                            *
                            
                            What are your potential plans for sharing Be Active Kids in your county?
                            		
                            *
                            
Our 2017 trainer expectations are for each trainer to:

a) Hold 2 Provider Trainings a year  OR  b) Hold 1 Provider Training AND share Be Active Kids in the community (through local library, community event, etc.)

                            Are there any barriers that you foresee to meeting our trainer expectations? If so, please list them below.
                            		
                            *
                            
                            Are there any other potential trainers in your county? If so, please provide their names and contact info below.
                            		
Thanks for your interest in Be Active Kids and for completing this questionnaire.  A Be Active Kids' staff member will be in touch with you shortly to discuss this unique training opportunity with you!  If you have questions or would like to speak with a Be Active Kids staff member, please contact us at 919-287-7012 or info@beactivekids.org.