GLI Request Form

Thank you for your interest the Google Learning Institute (GLI). To host an event at your site, please complete the form below. Dr. Mark Wagner, CUE's professional development coordinator, will be in touch with you as soon as possible. You may also contact Dr. Wagner at mwagner@cue.org or 949-639-9743.

Visit http://www.cue.org/cuetoyou/gli for more information on the Google Learning Institute before filling out this form.

* Required

Format * Please select a format for this event.

Single Lab Option
Single Room BYOL Option
Multiple Lab Option
Multiple Room BYOL Option

Registration * Please request a registration type for this event.

Group Registration: Your organization handles registration and pays CUE with a single check.
Individual Registration: CUE handles registration via an online system. Individual participants pay by credit card online.

Date * Please indicate the date on which you would like to host this event.

Time Please indicate the times you would like the event to begin and end. A GLI typically runs 8:30 am to 3:30 pm, but this is flexible.

Location * Please indicate the address of the location at which you would like to host this event.

Capacity Please indicate the capacity of the location.

Equipment Specifications Please indicate the operating system, software, peripherals, and Internet connection(s) available at the location. Include other technical details as necessary.

Installations If any specific hardware or software needs to be installed prior to the event, please indicate that below. Also, please indicate who will be responsible for the installations and provide contact information if possible.

Technical Support Please indicate who will be responsible for technical support at the location. (CUE requires on-site technical support for all hosted events.) Provide contact information if possible.

Logistical Support Please indicate who will be responsible for logistical support (such as registration) at the location. (CUE requires on-site logistical support for all hosted events.) Provide contact information if possible.

Audience Please indicate the primary audience for this event. Check all that apply.

Audience Level Please indicate the technical skill level of the anticipated audience.

Beginner
Intermediate
Advanced
Trainers (This is a train-the-trainers event.)

Notes Please indicate any additional information that will be necessary to adequately plan for this event.

Name Please indicate your name, including title and/or honorific if applicable.

E-mail Address Please enter (and verify) your email address.

Phone Number Please indicate the phone number where you would like us to contact you.

Fax Please indicate your fax number, if applicable.

Address Please indicate your mailing address.

Proposal Preparation Please indicate the name, title, address, email, and phone number of the person for whom the proposal should be prepared if you will not be signing the proposal.

Lead Learner Request If you would like to request a specific CUE Lead Learner to lead this event, please indicate his or her name here. You may request multiple Lead Learners here - simply separate their names with commas.