COIL on Wheels

Appointment Request Form

Form Instructions:
Please fill out the online form completely. Incomplete fields will cause an error in the submission process.

COIL on Wheels Request








Scheduling Options




Areas of Training

Check the topics for which your institution is requesting training workshop(s):














Please include any additional requests for training topics that might assist program coordinators in scheduling a successful training experience for your institution.


Facility Information

Please include information about training space (classroom, lecture hall, instruction room, etc.) at your institution. Be sure to include the following information:






ADA Statement

If you anticipate a need for special services for persons with disabilities, please indicate by checking this box. Please include information about the type of services needed, so that arrangements can be made in advance.