Target Learning, LLC
REQUEST FOR ON-SITE INDIVIDUAL INSTRUCTION

Company/Agency  

Website URL         

Contact Person     

E-Mail Address     

Telephone                  Ext.     Fax 

Street Address     

City                            State     Zip  

Coaching Participant's Name    

1.  Check the topics you would like to learn:

Listening Skills
Memory Improvement
Business Writing
Business Grammar
Strategic Reading
Speed Reading
Critical Thinking
Creative Thinking
Management/Supervision Skills
Train the Trainer
Communication Skills
Public Speaking
Team Building
Customer Service
Study Skills
 

2.  Please list any specific learning objectives you would like to accomplish.

3.  What problems or issues currently exist that warrant this instructional program?

4.  Please list any special training requirements, needs or considerations.

5.  What employment level are you currently at? (if in school, or not working, go to question 7)

Senior Management
Middle Management
Supervisor
Staff
Line Worker
Other

6.  What department do you work in? (if in school, or not working, go to question 7)

Administration
Information Technology
Engineering
Accounting
Legal
Marketing/Sales
Customer Service
Operations
Manufacturing
Shipping/Receiving
Security
Other

7.  If in school, what grade are you currently in?

9th Grade
10th Grade
11th Grade
12th Grade
College Freshman
College Junior
College Sophomore
College Senior
College - Graduate Level

8.  If not in school, what was the highest grade level you completed?

9th Grade
10th Grade
11th Grade
12th Grade
College Freshman
College Junior
College Sophomore
College Senior
College - Graduate Level
College - Post Graduate Level

9.  Do you have a preferred month for this individual instruction?

Unknown at this time
April 2012
May 2012
June 2012
July 2012
August 2012
September 2012
October 2012
November 2012
December 2012

10.  Do you have a preferred time of instruction?

Unknown at this time
Morning Sessions
Afternoon Sessions
Evening Sessions
Full Day Sessions
Weekend Sessions

11.  Do you prefer a set number of instructional hours?

Unknown at this time
2 hours
3 hours
4 hours
5 hours
6 hours
7 hours
8 hours
9 hours
10 hours
11 hours
12 hours
More than 12 hours

Questions? Contact Target Learning at:

(800) 692-1727
or
info@targetlearning.net