NEXT Steps Youth Entrepreneur Training Program
A Non-Profit Organization (501c3 tax status pending)
1890 Briarcliff Circle NE
Atlanta, Georgia 30329
678.570.0398
www.nextstepsyep.org
NEXT STEPS TRAINING REQUEST FORM
Customized Training Sessions Available!
Email completed form to djharris@nextstepsyep.org | Webform @ www.nextstepsyep.org
Our Training Guarantee
NEXT Steps YEP provides training using three key business tools: a business plan outline, the
CIGS Strategic Organizational Growth Model, and an event planning guideline toolkit. If you wish
for NSYEP to train your youth instructors, please send an email to djharris@nextstepsyep.org.
We guarantee our training tools will help you deliver quality, professional and measureable
results.
Please complete the form below and submit it to djharris@nextstepsyep.org or mail to: NSYEP,
Inc.c/o Dana Jewel Harris, 1890-A Briarcliff Circle NE, Atlanta, GA 30329. Upon receipt, you will
receive a confirmation email and follow-up call within 10 business days. At any time during your
training session request, please feel free to call or contact NSYEP, Inc. at 678-570-0398 or
djharris@nextstepsyep.org.
Contact Information
Name
Title
Organization/Company:
Address
City/State/Zip
Work Phone
Cell Phone
Work Email
Personal Email
Training Event Information
Event Title:
Event Date & Time:
Event Location:
Event Description:
Description of
Attendees (Age,
Education Level)*:
Other training being
offered:
Key Invited Officials
or Partners:
Invited Members of
the Press
Any promotional or
tie-in activities?
* This information is requested to ensure the training instructor can addresses the group appropriately.
NEXT Steps Youth Entrepreneur Training Program
Training Request Form
Page 2 of 4
_____
NEXT Steps Training Program Type
Please check the type of training you are interested in providing your students:
12 Week Training – Middle School (Youth ages 9-12) - $35/12-wk session
12 Week Training – High School (Youth Ages 13-18) - $35/12-wk session
12 Week Training – Young Adult (Ages 18-25) - $35/12-wk session
12 Week Training – Adult (Ages 25+) - $35/12-wk session
One Day Session (8 hrs) – Middle School/High School/Young Adult/Adult (circle one) -
$35/session
One Day Session (4 hrs) - Middle School/High School/Young Adult/Adult (circle one) -
$35/session
Customized Training Session. Please explain your needs in the space provided below.
Estimated No. of Attendees:
Training Fees: x $35.00
Total Amount Due: =
Please specify how you want us to keep you updated by marking an (x):
E-mail:_________ Snail mail:________
Total amount of pledged sponsorship = $___________________
Date you would like to start your training program:
Estimated completion date of your training program:
Your payment(s) for training will be sent:
□ One time □
Monthly □Quarterly □ Annually □ Beginning of Training
□ End of Training
Method of Payment
I would like to send a money order to NSYEP, Inc.
NEXT Steps YEP
c/o Dana Jewel Harris
1890-A Briarcliff Circle NE
Atlanta, Georgia 30329
I would like to pay by credit card monthly.
I would like to pay by credit card one-time.
To make secured payments by credit card, please visit our website at www.nextstepsyep.org.
Payments will be made through “Pay Pal”.
Electronic receipts will be provided to document your total contribution.
Training Survey
What is your desired training format?
In person
Web-based
Phone-based (via conference call)
NEXT STEPS YOUTH ENTREPRENEUR TRAINING PROGRAM
Dana Jewel Harris, Executive Director
678 570 0398 Direct
djharris@nextstepsyep.org | www.nextstepsyep.org
NEXT Steps Youth Entrepreneur Training Program
Training Request Form
Page 3 of 4
_____
What day and time would you prefer to conduct your training sessions on?
Monday Mornings (Time:__________)
Tuesday Afternoons (Time:__________)
Wednesday Evenings (Time:__________)
Thursday
Friday
Saturday
How would you describe your organization?
Community Partner (Name of Community: __________________________________)
Business (For-Profit)
Business (Non-Profit)
Youth Organization/Association
Government Entity
Have you conducted a NEXT Steps Training Program before?
Yes
No
Have you participated in a NEXT Steps Training Program before?
Yes
No
If yes, which one? Briefly describe in the space provided below.
Preferred Response Deadline Disclaimer
NSYEP Inc tries to schedule training sessions at least three to six months in advance. Please
feel free to submit your request at any time as we will make every effort to accommodate all
requests.
* Preferred response date by: ____________________________________
Service Programs/Upcoming Events
Please check which service programs or upcoming events your training should focus on.
Service Programs Upcoming Events
Leadership Training Jan-May NEXT Steps Winter/Spring Training Session
(Communities In Schools, Atlanta Community Partners)
Healthy Lifestyles May-July NEXT Steps Summer Internship/Job Fair
Social Responsibilities & Solutions (Mayor’s Youth Program)
(HIV/AIDS Awareness, Drug Use May-Aug NEXT Steps Saturday Training Sessions
(Seasonal)
Prevention, etc.)
Aug-Dec NEXT Steps Fall Training Session
Scholarship Opportunities (NSYEP Annual Conference)
Cross-Cultural/Cross-Continental Initiatives Jan-Dec Lyrical Concert Series (Special Events)
International Exchange Programs Nov-Dec NSYEP/NEXT Steps “At Your Service” Holiday
Research Programs on Civil & Human Banquet
Rights
NEXT STEPS YOUTH ENTREPRENEUR TRAINING PROGRAM
Dana Jewel Harris, Executive Director
678 570 0398 Direct
djharris@nextstepsyep.org | www.nextstepsyep.org
NEXT Steps Youth Entrepreneur Training Program
Training Request Form
Page 4 of 4
_____
Travel & Logistical Support Available
Can you provide any of the following travel support? Please mark all that apply:
Air
Lodging
Ground Transportation
Meals
Other (Please describe): ______________________________________________________
Can you provide any of the following exhibiting/materials support? Please mark all that apply:
Purchase of NSYEP materials for distribution
Shipping to event
Return shipping
Exhibitor fees
Equipment fees
Handling/Storage fees
Other (Please describe): ______________________________________________________
Can you provide any of the following training space & equipment? Please mark all that apply:
Training space to accommodate all participants
Tables and chairs to accommodate all participants
Adequate facilities for physically disabled persons
Laptop with DVD player Number of sets: _______
LCD Projector & Screen
Web-conference capabilities/software
Teleconference capabilities
If additional support is available, please identify for how many people and the source of funding:
Thank you for providing such vital support to NSYEP, Inc!
NEXT STEPS YOUTH ENTREPRENEUR TRAINING PROGRAM
Dana Jewel Harris, Executive Director
678 570 0398 Direct
djharris@nextstepsyep.org | www.nextstepsyep.org