e-Learning Corporate Learning Solutions Request Form

* Required Fields

Please fill out completely.

Determining your training needs
The questions below will help us to better meet your needs and prepare a customized information packet:

How many people are employed at your site?

* Number of people to access training:

Training audience composition (list percentage)

 % Engineers
 % Other (please list):

Timeframe when you want the e-Learning to be available (month/year):

* Select the e-Learning title you are interested in:
(Hold down the control key to select multiple e-Learning titles.)

Name of individual responsible for your training budget (if other than you):

How did you hear about Corporate Learning Solutions?

Contact information:

Customer Number:
* Name:
  Title:
* Company:
  Division:
* Street:
* City:
* State/Province:
* Country:
* Postal Code:
* Business Phone:
  Home Phone:
  Fax Number:
* Email: