The Parents' Place of Maryland Presentation/Workshop Request
Thank you so much for inquiring about our services!
Please answer the following questions so we can best assist you.
Please direct all questions to email@example.com
We are requesting
Name of Company/School/Organization
Contact Person First Name
Contact Person Last Name
Contact Person Email
Which county are you in?
Multiple - we serve Capital Region
Multiple - we serve Central Region
Multiple - we serve Eastern Shore
Multiple - we serve Southern MD
Multiple - we serve Western MD
N/A - we serve a statewide audience
N/A - not in Maryland
N/A - we serve a national audience
What topic would you like us to present on?
Disability/Health Specific (please specify)
Family Engagement/Family Empowerment
How to support families when English is not their First Language
Parent Empowerment Program 5-12 (Charles County)
Parent Empowerment Program Teens (Charles County)
Preparing for School
Serving on Groups
Special Education 101
Special Education/General Information/504 (please specify)
Transition: Birth to 5
Transition: 14 to 21
Other Topic/Provide more information
Preferred Delivery Type
How many participants do you expect?
**Please note that PPMD cannot host more than 100 participants via Zoom, so you would be responsible providing the digital platform for hosting IF your event will be virtual or hybrid and will have 100+ participants.
Do you need PPMD to provide the digital platform for the training?
Please select your target audience:
Families/Caregivers (ie parents, grandparents, etc)
How are participants registering to attend?
Will you have evaluations at the end of the event?
We can provide evaluations for you, what information would you like captured?
Will you be able to send your evaluations within 5 days of the event?
Have you already spoken with a PPMD staff member?
Who did you speak with?
Are you requesting a specific PPMD staff member to conduct the training?
Preferred PPMD staff member
What is your overall goal of the training?
Any additional information you think would be helpful for us to know?
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