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Required format:

ayYxLYXPqoDofjboQxIrH8sWzDnHTu4mGQxnTcDXcqvEMZaewU973

PEARLS Train-the-Trainer Course Registration

Thank you for your interest in attending our PEARLS Train-the-Trainer course! This training teaches experienced PEARLS Coaches how to train new PEARLS Coaches to provide the program through a series of seven webinars (one per week for seven weeks), each lasting 90-minutes.

Dates for the Fall 2024 Train-the-Trainer course:

To become a PEARLS Trainer, you must have completed the PEARLS Coach Training and successfully enrolled at least 10 PEARLS participants.

Cost of the PEARLS Train-the-Trainer course is $700 per person, and registration for the Fall 2024 training is open through September 4, 2024, or until we reach capacity.

If you have questions, or are unsure about your eligibility to participate in the Train-the-Trainer course, please reach out to us at uwpearls@uw.edu.

Training Cohort:

Today's Date:

* must provide value

M-D-Y

Are you completing this registration for yourself, or someone else?

* must provide value

I am registering myself

I am registering someone else/others

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About the Trainee
First Name*:
Last Name*:
Preferred Pronouns (check all that apply):
Role/Job Title:
Email*:
Direct/Office Phone #:
→ Extension:
Cell Phone #:

First and Last Name will be used to generate the Certificate at the end of training
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Course Name

Course: PEARLS Trainer Training

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Your Contact Information
First Name:
Last Name:
Email:
Role/Job Title:

About Your Organization
Organization Name*:
Street Address*:
Suite, Unit, etc.:
City*:
State*:
Zip Code*:
Website:
Phone Number:

*must provide value

PEARLS Equity Org ID:

Would you like us to add your Organization's information to our national database of PEARLS Programs, after training is completed?

This information is shared when we are contacted by organizations or referrals looking for programs in their area.

Yes

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What type of organization do you work for? (check all that apply)

Social service

Health care

Public health

Faith-based

Food access

Area Agency on Aging

Senior Center

Other:

Is your organization already doing PEARLS?

Yes

Not Sure

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Communities Served: (check all that apply)

Older adults

People of color

People who speak languages other than English

Rural dwellers

People living in poverty

LGBTQ+

Other:

Please specify the communities of color you plan to engage: (check all that apply)

American Indian / Alaska Native

Asian

Black / African American

Hawaiian / Pacific Islander

Multi-racial

Other, please specify:

Please specify language(s):

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PEARLS Train-the-Trainer Course Registration

Contact Information

About the Trainee

Your Contact Information

Organization Information

About Your Organization

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