Online Class Special Request

Please complete the request form below and we will contact you.

Agency Name * Required
Desired Online Class * Required
Approximate number of students * Required
Name * Required
First Last
Phone * Required
Email * Required
Does your Agency have a CJI Membership? * Required
Desired Start Date * Required
MM slash DD slash YYYY
Note: We may not be able to schedule a class on the specific date requested, but will make every effort to meet your needs. Please indicate your desired class start date in the box below or any other comments or questions. Please submit your request at least 2 weeks prior to the start date.