Departmental Request for Professional Development

To provide the best possible service, Learning Services will coordinate with your department's Management Consultant. Together we will conduct an assessment to ensure that the most appropriate and effective method is utilized to meet your request and the department's needs. To start this process please complete the form below.

Contact Information

*Required Fields

*Department Name   *Department Supervisor

*Contact Person   *Contact e-Mail  

*Contact Phone

About Your Request

Please check all that apply.

Training Programs*    Learning Needs Assessment    Diversity Consultation Requests Organization Development

    *If selecting Training Programs, please indicate the level of training needed.

    Introductory    Intermediate    Advanced    Unsure

Number of People:

Are they:

Background Information

*Why are you requesting this learning opportunity at this time?

*Describe recent changes in your department that influence this request.

*What outcome do you hope to achieve as a result of this assessment or learning opportunity?

*What other information would be helpful to know as we respond to your request?

*Topics Requested

Exisiting Plans

Does your department currently have: (Check all that apply)

Departmental Learning Plan    Diversity Plan   


Please indicate if you will need any of the following accommodations:

Closed Captionioning    ASL Interpreter    Mobility/Physical Access Needs