Accessing Safety Initiative
Session Design Form

Thank you for agreeing to develop and implement a training for the Accessing Safety Initiative. Please provide us with an overview of this training by completing this form as instructed.  


General Information
Please provide us with the following general information about the training that you have developed. 

Title:

Duration:

Facilitator(s):



Training Details

1. What are the goals for this training?





2. What are the objectives for this training? In other words, what will participants be able to do by the end of the training?






3. What handouts, if any, will you provide to participants?





4. What training materials will you need (i.e. flip chart paper, markers, tape, power point, etc.)?



5. How will you need the room set-up?


Training Agenda
Please provide us with a brief lesson plan outlining how you will achieve the goals of the workshop session you have designed. Be sure to provide us with sufficient detail on your facilitation technique. For example, if you are planning to use an activity, please outline the activity in detail.  Also, estimate the time you are devoting to each topic during this session.

Time	
Topic and Facilitation Technique