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January 2006

Dear Region 1 DD Training Co-op Member:

Welcome!
The Training Advisory and Steering Committee (TASC), the managing and oversight group of
the Region I DD Training Co-op is happy that you have decided to join and/or continue in this
new adventure. With 33 voluntary Co-op members we have been able to put together what we
think is a fabulous training schedule for 2006.

Enclosed is your "Host Kit". This has been provided to help you organize your hosting process
and streamline forms to make your experience in hosting a community-wide training enjoyable.

"Host Kit" includes:

-   Annual Plan/Master Schedule                     -   List of Instructors & Courses
-   List of Mentors for each Host Agency            -   List of Training Sites
-   Financial Risk of Hosting Co-op Class           -   Flyer & Registration Template
-   Fee Worksheet                                   -   Class Roster Form
-   Suggestions for OIS Co-op Hosts                 -   Completion Report Form
-   List of TASC Members                            -   Evaluation Form
-   List of Co-op Members                           -   Certificate Template

General Information:

- If you know of other agencies who are interested in becoming a Co-op member, please have
  them contact their County's TASC representative (see list of TASC members) for a Co-Op
  application and more information. TASC representatives will contact them when enrollment
  re-opens.

- In 2006 like 2004 & 2005, members are assigned 1-3 classes they are responsible to host
  host. If you have questions please call your assigned mentor from the list in this kit.

- Please do NOT make changes to the Annual Plan/Master Schedule yourself. Call the Host
  Kit Keeper and your Mentor if you are unable to have your class in the target month.
     You must plan a new date or target month and follow through!
     If you need to make a full trade, please follow instructions below.
- Please allow TASC committee members to attend classes free of charge to monitor quality
  of classes and to help answer any questions about the Region 1 DD Training Co-op.

- The website will be periodically updated. Please check it often for the most current
  class information and course descriptions available!

- This Annual Plan/Master Schedule runs January to December.

Co-op Member Agency Responsibility:
- Assign a Contact person to receive and distribute Co-op Class flyers among your agency's
"circle". This person will take the lead for seting up, sending publications to E-mail Keeper,
                                                                                                    Page 2

and hosting the 1-3 classes (usually 1-2) assigned on the Co-op Annual Plan/Master Schedule.
Monthly Contact Person's Flyer Distribution Responsibility

- Send out all monthly flyers sent from E-mail Keeper from other host agencies to your "circle"
 such as, your staff, individuals and families, and individual subcontractors as soon as you can.
Counties will send flyers to Foster Care Providers.

What Do I Do When It is My Turn to Host a Class?

Three (or four) months prior to your assigned class:

- Review "Host Kit" sent to you by the Host Kit Keeper. Every time you receive a "Host Kit"
   from the Host Kit Keeper you should replace the previous one with it. If you want it earlier,
  contact the Host Kit Keeper or your TASC Mentor contact, who should be able to send it to
  you by e-mail in Excel or other available format.

THREE months prior to an assigned class:

- Monitor/track all hours spent coordinating and hosting your class.

- Check the Annual Plan to see who else is hosting a class in your same month.
  Coordinate with those other Co-op member contacts planning classes to ensure that
  your classes are scheduled on different days.

- Secure instructor, training site, date, time and equipment needed. Pay any related costs.
  Determine your registration fee per person (see fee worksheet tab below) and form of
 payments that are acceptable. Set up a process and person in your agency to process
 registrations. E-mail flyer and registration form to E-mail Keeper for distribution to all
 co-op member contacts by the MIDDLE OF THE MONTH TWO MONTHS PRIOR to the
 DATE of the CLASS (For Example: for a June Class, flyers should be out to the E-mail
 Keeper by April 15th) and begin to take registration fees (i.e. $10.00 & up). All fees must
 be paid in advance for one to be considered registered. Fees for non-Co-op members are
 double those for Co-op members. Non-members are generally staff of agencies who opted
 not to join the Co-Op. Families of consumers are always allowed in at member rates.

- Website Keeper (SDRI for 2005-06) is a member of the Co-Op so when receiving the flyer will
  know to update website with your current class information (class title, instructor, date, time
  location/address, fee per person, contact person for registration, and contact person for
 questions if different.)

- After a week, double check that the Website Keeper has updated your class with the correct
  information. If corrections are needed, contact Website Keeper promptly.

- Send out flyers to your staff and individual subcontractors.

- Tally all hours spent coordinating and hosting class.

Week prior to class:

- Set aside at least 50% of the capacity for Co-op members. Any space remaining a week
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 prior may all be used for host's staff or individual subcontractors.

- If registration is less than 10 or other minimum number set by instructor, the class may be
  cancelled. Co-op hosting responsibility will be considered met. Registrants, E-mail Keeper,
  Host Kit and Website Keeper must be notified ASAP.

- Reconfirm logistics with instructor and training site coordinator.

Day of class:

- Prepare room/restrooms, equipment, simple snack and beverage (coffee, tea, cookies,
  crackers, muffins, fruit, etc.), sign-in roster with pre-registrants names, evaluations, and
 Certificate of Completion for each registrant.

- If you are accepting walk-ins, be prepared to accept registration fees.

- Make copies of instructor's handouts to give to registrants. (Please also send copies
  to Paper Keeper with your completion packet.)

- Introduce the instructor and explain any logistics to the registrants.

- Collect your evaluations and hand out Certificates.

Two weeks after class:

- Submit one copy of class handouts, all evaluations, the completion reports and the final
  Roster to the Paper Keeper.

- To update any changes or additional information (i.e. training site, course, instructor list,
  etc.) for Host Kit please contact the Host Kit Keeper.

- If you have a request for replacement of a lost certificate direct them to the Paper
  Keeper and inform them of a charge of $5 per certificate replacement. Keeper can only
  replace certificates for those she has received rosters. Payments go to the Paper
  Keeper's agency. The Paper Keeper will send certificate to registrant upon receiving
  payment and confirming attendance.

What if I can't meet my Hosting Responsibility?:
- Decide within 2 weeks of receiving reminder e-mail whether you can host as assigned.
- If unable to host as assigned, seek a straight across trade with another Co-op Member
   and notify Host Kit Keeper of change.
- If unable to trade, convince another Co-op Member to host the assigned class for you.
- If unable to convince another Co-op Member to host for you, create an e-mail explaining
   why you are unable to host and requesting a Co-op Member Volunteer to host the class
   and forward it to the E-mail Keeper for distribution.
- If no volunteer is identified, create an e-mail explaining that the class will be cancelled
   and forward it to the E-mail Keeper for distribution. Also create a plan to meet future
   hosting commitments or notify the TASC that your agency will be withdrawing from
   the Region I Training Co-op.
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Centralized Website and link:
http://sdri-pdx.org/training/co-op
Follow the Region 1 DD Training Co-op link

Key Contacts for 2005:
Please free to call upon your mentor or any TASC members for more information.

Host Kit Keeper:                                             Website Keeper:
Robyn Hoffman, Clackamas County                              Michael Gmirkin, SDRI
robynhof@co.clackamas.or.us                                  michael@sdri-pdx.org
503-557-2872                                                 503-292-7142

E-mail Keeper:                                               Paper Keeper:
Robin Wiggin, Region I Crisis Diversion Office               May Nelson, Inclusion Inc.
robin.g.wiggin@co.multnomah.or.us                            3608 SE Powell Blvd.
503-988-3703 xt. 222                                         Portland, OR 97202
                                                             503-232-2289 xt. 112

***To review other "pages" of this Host Kit please put your cursor on the selected grey tab below.
( If the tab you desire is not visible, use the triangle shaped arrow keys on the bottom left to
scroll back and forth through the tabs. The triangle arrow keys on the right with move you
left and right on each page.)
X = Completed                                 Region I Training Co-op Annual Plan 2006
P = Postponed
C = Cancelled   IMPORTANT: Assigned classes MUST be set up & publicized MINIMUM 2-3 months ahead!

M
                   HOST AGENCY                               CLASS TOPIC                         INSTRUCTOR
O


       Multnomah County DD                     Parole and Probation                     Sandra or Kevin Bowers
J
A
       Good Shepherd                           Working with Survivors of Abuse          Mike Larson
N
U
       Self Determination Resources Inc.       Leading Psychosocial Groups              Val Valrejean or Lee Greer
A
R
       Abertina Kerr Centers       carold@albertinakerr.org
                                               OIS - General                      OIS - General
                                                                                         Carol Dinsmore, Mentor Trnr
Y

       Rainbow Adult Living                    Medical Record Keeping                   Mike Malchow-Hay


F
E      Goodwill                                Intro to DD                              Robin Wiggin
B
R      Region 1 Crisis Diversion               Understanding Behavior                   Mike Larson/Dave Langlois
U
A      Washington County                       Fatal Four - Beaverton                   State RN
R
Y      Inclusion Inc                           Getting off the Guilt Roller Coaster     Lee Patton, PhD

       Eastco Diversified Services             Aging Issues                             Warren Bird or TBD



       Adult Learning Systems                  OIS-General Level                        Mentor Trainer TBD
M
                                           Recreation Options for People with DD
        Social Recreation Companionship Program                                         Agency Trainer or TBD
A
R
       Coast Multnomah                         Autism 1                                 Mike Larson
C
H
       Rainbow Adult Living                    Communication                            Denise Allen
       Integrated Services Netwk               Fatal Four (in Clatsop Co)               State RN - Clatsop



       Dungarvin                               Attachment Disorders & Brain Function    Mike Larson/Dave Langlois
A
P
       Clackamas County DD                     Users Guide to the DD System             Jessica Leitner
R
I
       Arc of Multnomah                        Special Needs Trust Planning             Mitch Teal
L

       Community Access Services               Down Syndrome and Aging                  Lori Thompson

       Up & Out                                Drug & Alcohol Dependency                Jerry Annand, MA


       OESCo                                   Fatal Four                               State RN's
M
       Developmental Systems Inc.                                                    Robin
                                               Money Management (for people in DD Services) Wiggin
A
Y
       Riverside                               OIS - General Level                      Mentor Trainer TBD

       Oregon Industries for the Blind         Autism 2                                  M Larson /Jane Rake

       PASS                                    Basic Behavior (2)                       Julie Snook



       Clackamas County DD                     Working with Protective Services         Tom Zaner

J      Region I Crisis Diversion Office                                               Mike Larson
                                               Positive Programming-Sexually Aggressive Behavior & Dave Langlois
U
N      Clatsop County DD                       Sign Language I                          Miriam Berman or TBD
E
       Multnomah County DD                     Intro to DD                              Robin Wiggin

       Arc of Multnomah                        Guardianship                             Elaine Friesen-Strang


       Clackamas County DD                     OIS-General Level                        Toi Gibson, Mentor Trainer

J      Port City Development                   Team Building                            Regina Kalandros-Simmons
U
L
       Washington County DD                    "Welcome to my World"                    Lori LeDuc
Y
       Good Shepherd                           Diabetes Management                      Helen Emmons RN, State RN

       Community Vision                        Autism 1                                 Mike Larson



A U    Coast-Clatsop                                                                 Robin
                                               Money Management (for people in DD Services) Wiggin
 G
U S    Mt. Angel                               Dual Diagnosis                           Dan Baker or TBD
 T
       CCI Enterprises                         Brainstorms & Seizures                   Jill Foresman, Epilepsy Association

       Albertina Kerr Centers                  OIS-General Level                        Carol Dinsmore, Mentor Trnr
X = Completed                              Region I Training Co-op Annual Plan 2006
P = Postponed
C = Cancelled     IMPORTANT: Assigned classes MUST be set up & publicized MINIMUM 2-3 months ahead!

M
                   HOST AGENCY                           CLASS TOPIC                       INSTRUCTOR
O



S      Oregon Industries for the Blind     Intro to DD                             Robin Wiggin
E
P      Community Vision                    Autism 2                                Mike Larson / J Rake
T
E
M
       Washington County DD                IEP & Transitions Issues                Julie Snook
B
E      Community Services Inc.             Obsessive-Compulsive Disorders          James Clay, PsyD or TBD
R
       Senior Center Project               Diabetes                                State RN



       PASS                                User's Guide to the DD System           Jessica Leitner
O
C      Rainbow Adult Living                Sign Language I                         Miriam Berman or TBD
T
O
B
       Eastco Diversified Services         Personality Disorders                   James Clay, Psy D (ORA)
E
R      Dungarvin                                                                  Mike Larson & Dave Langlois
                                           Positive Programming-Sexually Aggression

                                           Fatal
       Social Recreational Companionship ProgramFour                               State RN


N
O
       Mt. Angel                           Autism Topic                            Rick Newton
V
E      Tualitin Valley Workshop             Attachment Disorder & Brain Function   Mike Larson/Dave Langlois
M
B      Inclusion Inc                        OIS - General Level                    Toi Gibson, Mentor Trainer
E
R
       Danville                            Fetal Alcohol Syndrome                  Lori Thompson


D
E      Community Access Services                                                  Robin Wiggin
                                           Money Management (for Individuals in DD Services)
C
E
M
       Goodwill                            Understanding Behavior                  Mike Larson & Dave Langlois
B
E      Community Services Ince             Pica                                    Helen Emmons or Diana Scott, Sta
TASC MENTORSHIP LIST (M's advise of hosting & other Co-Op activities)
         Host Agency              Mentor        Phone          Mentor Agency
Adult Learning Systems       Susan Norman    503-667-0613    Eastco
Albertina Kerr Centers       Robyn Hoffman   503-557-2872    Clackamas Cnty DD
Arc of Multnomah             May Nelson      503-232-2289    Inclusion, Inc.
CCI Enterprises              Robyn Hoffman   503-557-2872    Clackamas Cnty DD
Clackamas County DD          Robyn Hoffman   503-557-2872    Clackamas Cnty DD
Clatsop County DD            Robyn Hoffman   503-557-2872    Clackamas Cnty DD
Community Access Svc.        Jerri Rudacil   503-846-5743    Washington Cnty DD
CBAP Social Recreation       Wendy Taliaferro 503-292-7142   SDRI
CSI                          Robin Wiggin    503-988-3703    Region 1 Crisis Div.
Community Vision             Wendy Taliaferro 503-292-7142   SDRI
Coast Rehab - Clatsop        Susan Norman    503-667-0613    Eastco
Coast Rehab - Mult.       Susan Norman       503-667-0613    Eastco
Danville                  Wendy Taliaferro   503-292-7142    SDRI
Deveopmental Systems, Inc Wendy Taliaferro   503-292-7142    SDRI
Dungarvin                 Jeri Rudacil       503-846-5743    Washington Cnty DD
Eastco                       Susan Norman    503-667-0613    Eastco
Good Shepherd                Jerri Rudacil   503-846-5743    Washington Cnty DD
Goodwill                     May Nelson      503-232-2289    Inclusion, Inc.
Inclusion, Inc.              May Nelson      503-232-2289    Inclusion, Inc.
Integrated Services Netwk    May Nelson      503-232-2289    Inclusion, Inc.
Mt Angel Training Center     Robyn Hoffman   503-557-2872    Clackamas Cnty DD
Multnomah Cnty DD            Robyn Hoffman   503-557-2872    Clackamas Cnty DD
OESCO                        Wendy Taliaferro 503-292-7142   SDRI
PASS                         Robyn Hoffman   503-557-2872    Clackamas Cnty DD
Port City Development        Robin Wiggin    503-988-3703    Region I Crisis Div.
OIB                          Susan Norman    503-667-0613    Eastco
Rainbow Adult Living         Robin Wiggin    503-988-3703    Region 1 Crisis Div.
Region 1 Crisis Diversion    Robin Wiggin    503-988-3703    Region 1 Crisis Div.
Riverside Training Centers   Robin Wiggin    503-988-3703    Region 1 Crisis Div.
SDRI                         Wendy Taliaferro 503-292-7142   SDRI
Senior Center Project        May Nelson      503-232-2289    Inclusion, Inc.
Tualatin Valley Workshops    Jeri Rudacil    503-846-5743    Washington Cnty DD
Up and Out                   Jeri Rudacil    503-846-5743    Washington Cnty DD
Washington Cnty DD           Jeri Rudacil    503-846-5743    Washington Cnty DD
           FINANCIAL RISK AND HOSTING REGIONAL CO-OP CLASSES
If you have been selected to host a class that requires using a trainer with a fee, there are a few
things to keep in mind. First and foremost, no co-op member should accept sustaintial financial loss
as a result of being a member of the co-op. Second, there are ways to aviod taking a financial hit for
hosting a class.
              1. When you are negotiating a rate/contract with the trainer make sure to ask these
            questions in addition to all the other logistical questions:
                    * What is the maximum number of students you will allow in the class?
                        Are there printed materials? Do you provide them? Is that cost included in
                    * the training?
                    * Will you sign a contract/commit to this training that will allow for a 1 week
                        cancellation notice with NO CHARGES if we are unable to get enough
                        registrants?
             2. Calculate the total cost to your agency based on the following:
                    Instructor fee fee
                            Instructor
                    Printing costscosts of materials/handoutsflyers
                            Printing of materials/handouts & & flyers
                    Snacks/beverages -- if you are providing
                            Snacks/beverages--if you are providing
                    Room reservation fee -- if you are not using a a freespace
                            Room reservation fee--if you are not using free space
                      Number of your staff attending (how much would you be paying to send them
                    elsewhere to of your staff same or similarmuch would you be paying to send them elsewhere to
                          Number receive the attending (how training)
                      Number of registrants/attendees that trainer and /or space will allow

            3. After you have considered all of the above cost factors, you should be ready to
           calculate the registration fee that you will charge participants. When you are figuring the
           costs per person, it is safe to assume you may fall short a few registrants. Set the
           minimum number of registrants you need to be comfortable with your agencies costs.


            4. Advertise your class with roughly a two and a half month advance. If within 2 weeks
           of the class you are not near your minimum number of registrants, contact the E-mail
           Keeper. The TASC will assist in trying to fill your class. If within 1 week of the class you
           do not have enough registrants to recoup enough of your costs, cancel the class.
             5. See the attached fee worksheet for figuring out costs and registration fee.
Class: Training for People Doing Trainings
Instructor: Joe Trainer

Description                     Cost per unit/person             total cost
Instructor Fee                    $200.00                                $200.00
room reservation                     $0.00                                  $0.00
materials                            $1.50                                $45.00
snacks                               $2.00                                $60.00
other
                                              total cost
                                              to agency:                $305.00


maximum number of students               30
# of students from our agency             4
total # of paying students               26

cost per student from outside agency                   $11.73
cost per student if 10% below registration             $13.03

registration fee                              $15/student
minimum acceptable outside registrants                      22
                                   SUGGESTIONS FOR OIS CO-OP HOSTS

Hosting the OIS training does involve some possibility of financial risk for co-op members. The below
suggestions are to help minimize risk for your organization.




    It is critical to understand that there are only select OIS trainers (OIS Mentor Trainers) who have
    appropriate certification to do OIS training outside of their own agency. There are a number of trainers
  1 locally who have this statewide training certification. These trainers include (not comprehensive):

    John Mushlitz     503-317-5880                            $600   Will use co-trainer/manuals negotiated
    Julie Beaton      503*481-5172                            $600   Will use co-trainer/manuals negotiated
    Mike Larson       503-788-2731                            $600   Will use co-trainer/manuals negotiated
    CCI               503-594-1250 ext 27                     $600   Contact Kelley Gordham--has 4 trainers available + co-trainers


    If trainers use a co-trainer they can increase the number of class participants to 22. Ask the trainers about
    this possibility because it will decrease the cost per student and, hopefully, help insure enough participants
    to cover the cost of the trainer. Having 22 participants should lower the registration cost to $40 or below.
  2 If your cost is more than $40 you may not get enough attendees.
    Negotiate with trainer how manuals are provided. Some may charge extra for the supplying manuals.
    Printing costs can be as high as $5-6/each. Even if you print the manuals your cost would be roughtly
    $33.28 per person if you have 22 enrollees. If you negotiate that the manuals are covered by trainer, then
  3 your cost per person is $27.28 with a full class.
    Don’t forget that you should provide some beverage and light snack -- add a few dollars per person for this
  4 cost. Once you have figured your approximate costs, set your registration fee.
    The room also needs to be reserved for 2 full days, accommodate up to 24 people and have space for both
  5 the brain work and the physical practice portions of the training.
    You need to decide when you are setting your registration fee amount whether you are willing to accept
    any financial loss and set a minimum number of attendees based on your decision. OIS usually fills up
    quickly so you should not have a problem filling a class if it is well advertised to co-op members. However,
    in the event you do not get the minimum mumber of attendees you need contact the E-mail Keeper and
    ask for help filling spots. If you still do not get enough registrants, cancel the class. No co-op member
  6 should have to absorb large financial losses as a result of being a member!
                                                         T.A.S.C. Members
      NAME                    AGENCY                      PHONE #                              E-MAIL                            ADDRESS
Robin Wiggin                                        503-988-3703 xt 222 robin.g.wiggin@co.multnomah.or.us           4850 SW Scholls Ferry Rd., #104
                   Region I Crisis Diversion Ofc.
E-mail Keeper                                                                                                       Portland, OR 97225
Robyn Hoffman                                       503-557-2872           RobynHof@co.clackamas.or.us              524 Main St.
                   Clackamas County DD
Host Kit Keeper                                     503-723-4933 Fax                                                Oregon City, OR 97045
May Nelson                                          503-232-2289 xt 12     may@inclusioninc.org                     3608 SE Powell Blvd.
                   Inclusion, Inc.
Paper Keeper                                        503-235-6914   Fax                                              Portland, OR 97202
Wendy Taliaferro                                 503-292-7142 xt.17        wendy@sdri-pdx.org                       1730 SW Skyline Blvd., Ste. 127
                   SDRI - Self Determination Resources Inc.
Michael Gmirkin                                             xt.10          michael@sdri-pdx.org                     Portland, OR 97221
Website Keeper
Jerri Rudacil                                       503-846-5743           jerri_rudacil@co.washington.or.us        3700 SW Murray Blvd., Ste. 300
              Washington County DD
                                                                                                                    Beaverton, OR 97006
Susan Norman                                        503-667-0613           snorman4@eastcodiversifiedservices.com   PO Box 470
                   Eastco Diversified Services
                                                                                                                    Gresham, OR 97030
Elaine Petersen                                     503-988-3658 x 26361 elaine.a.petersen@co.multnomah.or.us       421 SW 6th, Ste. 400
                   Multnomah County DD
(inactive)                                                                                                          Portland, OR 97204-1621
            MEMBER                   CONTACT           PHONE #       EXT                       E-MAIL                         ADDRESS
 1 Adult Learning System       Brett Turner          503-254-1622             bturner@alsoweb.org                  4110 NE 122nd, Ste. 150
   of Oregon, Inc.                                                                                                 Portland, OR 97230
 2 Albertina Kerr Center       Carol Dinsmore        503-262-0158             carold@albertinakerr.org             722 NE 162nd Ave.
                               Danielle Mathes        503-408-5038      Fax   daniellem@albertinakerr.org (tent)   Portland, OR 97230
 3 Arc of Multnomah, The       Marilyn McMahan       503-223-7279       616   mmcmahan@thearcmult.org              619 SW 11th, Suite 106
                               Bill Smook                                                                          Portland, OR 97205
 4 C.C.I. Enterprises          Ken Fosheim           503-652-9036             kenf@ccienterprises.org              5285 SE Mallard Way
                               Bob Stuva             503-652-9036             bstuva@ccienterprises.org            Milwaukie, OR 97222
 5 Clackamas County DD         Robyn Hoffman         503-557-2872             robynhof@co.clackamas.or.us          524 Main St
                               Adrienne Miller       503-723-4933             adriennemil@co.clackamas.or.us       Oregon City, OR 97045
 6 Clatsop County DD           Trish White           503-338-3600             twhite@co.clatsop.or.us              800 Exchange St, Suite 400
                                                                                                                   Astoria OR 97103
 7 Coast Rehab -               Jim Ciminello         503-861-3372             jciminello@coastrehab.org            65 N. Highway 101, Ste. 205
    Clatsop County                                    503-861-3476      Fax                                        Warrenton, OR 97146
 8 Coast Rehab Services -      Shawna Crase          503-491-5005             scrase@coastrehab.org                333 SE 223rd, Ste. 103
    Multnomah County                                                                                               Gresham, OR 97080
 9 Community Access            Arlene Baksay         503-533-4373             arlene@CAS-DD.org                    1815 NW 169th Place, Suite 1060
   Services                    Kathy Haines                                   kathy@CAS-DD.org                     Beaverton, OR 97006
10 Social Recreation       John Goff                 503-359-2512             john@awloutdoors.com                 1431 Pacific Ave
   Companion Program (aka AWL)                                                                                     Forest Grove, OR 97116
11 CSI -                       Carol Baron           503-648-6415             cbaron@cs-inc.org                    1982 NE 25th Ave., #1
    Community Services, Inc.                         503-204-9301       Pgr                                        Hillsboro, OR 97124
12 Community Vision            Michelle Dougherty    503-292-4964       112   shellnrocky@yahoo.com                1750 SW Skyline Blvd., Ste. 102
                                                                                                                   Portland, OR 97221
13 Danville                    Mike Oliver           503-228-4401       106   moliver@danserv.com                  3323 SW Naito Parkway
                                                                                                                   Portland, OR 97239
14 D.S.I. - Developmental      SarahKnight           503-258-2440             sarah.knight@thementornetwork.com    305 NE 102nd, Ste. 100
    Systems, Inc.                                                                                                  Portland, OR 97220
15 Dungarvin                   Cheryl Olson          503-624-0205             colson@dungarvin.com                 7320 SW Hunziker, #101
                                                                                                                   Portland, OR 97223
16 Eastco Diversified          Susan Norman          503-667-0613             snorman4@eastcodiversifiedservices.com Box 470
                                                                                                                   PO
   Services                                         cell 503-309-2456                                              Gresham, OR 97030
              MEMBER                 CONTACT           PHONE #        EXT                     E-MAIL                            ADDRESS
17 Good Shepherd               Melody Wold            503-310-4354            MWold@gscommunities.org               7931 Halsey St., Ste. 305
   Communities                                         503-261-0259    Fax                                          Portland, OR 97213
18 Goodwill Industries         Becki Martin           503-238-6199            bmartin@gicw.org                      1943 SE 6th Ave.
                                                                                                                    Portland, OR 97214
19 Inclusion, Inc.             May Nelson             503-232-2289      12    may@inclusioninc.org                  3454 SE Powell Blvd.
                                                                                                                    Portland, OR 97202
20 I.S.N. - Integrated         Cindy Nofield          503-325-0241      30    cshuler@seasurf.net                   #10 6th St., Ste. 103
     Services Network          Joyce Rangila x50       503-338-8176    Cell   jrangila@seasurf.net                  Astoria, OR 97103
21 Mt. Angel Training Center   Rick Newton            503-845-9214            rckne3@mtangel.com                    PO Box 78
   & Residential Services                                                     jobdev@mtangel.net                    Mt. Angel, Oregon 97362
22 Multnomah County DD         Geneale Turner         503-988-3658 28597 geneale.turner@co.multnomah.or.us          421 SW 6th
   Services                                                                                                         Portland, OR 97204
23 OESCO                       Mary Ellen Baldauff    503-774-1667            maryellenb@oescorp.org                PO Box 82698
                                                      503-288-5855                                                  Portland, OR 97282
24 Oregon Industries for the   Desiree Paschall       503-236-2147            dpaschall@teleport.com                905 SE Ankeny St.
   Blind                                                                                                            Portland, OR 97214
25 PASS                        Amy Vauthier           503-262-9322            pass_pdx@hotmail.com                  10700 SE Division
                                                                                                                    Portland 97266

26 Port City Development       Rose Hart              503-236-9515            rose@portcitydevelopment.org          2124 N. Williams Ave.
     Center                                                                   info@portcitydevelopment.org          Portland OR 97227
                                                                      and/or> Carlos@portcitydevelopment.org

                                                      5
                               Regina Kalandros-Simmons 03 890 0157           artprogram@portcitydevelopment.org

27 Rainbow Adult Living        Mary Brottlower        503-287-5100            rainbowadultliving@msn.com            520 SE 29th
                               Paula Kerns             503-232-0394     28    pjkerns@msn.com                       Portland, OR 97214
28 Region I Crisis             Robin Wiggin           503-988-3703     222    robin.g.wiggin@co.multnomah.or.us     4850 SW Scholls Ferry Rd., #104
     Diversion Office                                                                                               Portland, OR 97225
29 Riverside Training          Cindy Stockton         503-397-1922            cindy.stockton@riversidecenters.com   PO Box D
   Centers, Inc.                                                                                                    105 Port Ave.
                                                                                                                    St. Helens, OR 97051
30 S.D.R.I. -                  Wendy Taliafero        503-292-7142            wendy@sdri-pdx.org                    1730 SW Skyline Blvd., Ste. 127
     Self Determination        Michael Gmirkin                                michael@sdri-pdx.org                  Portland, OR 97221
            MEMBER                 CONTACT     PHONE #       EXT                    E-MAIL                       ADDRESS
    Resources, Inc.
31 Senior Center Project -   Jane Doyle       503-823-4328         jdoyle@ci.portland.or.us            426 NE 12th
    Portland Parks & Rec.                     Fax 823-4329                                             Portland, OR 97232
33 Tualatin Valley           (vacant 12/05)   503-649-8571                                             6615 SE Alexander
   Workshop, Inc.                                                                                      Hillsboro, OR 97123
34 Up & Out Inc.             Renee Kibbee     503 796-0241         MyTwtee@aol.com                     521 SW 11th #304
                             Kathy Kirby                                                               Portland OR 97205
35 Washington County DD      Jerri Rudacil    503-846-5743         jerri_rudacil@co.washington.or.us   3700 SW Murray Blvd., Ste. 300
                                                                                                       Beaverton OR 97006
                                                                                          Page 15

   Resource Info: Instructors / Course Topics
The following is a list of instructors for training classes that have been taught in the past
for the Regional Training Program (particularly the former Region II). It is a useful resource
 for reference only. It should not be considered up to date. The list is not necessarily in
alphabetical order. Prices listed below are not indicative of current charges.If you have other
suggested resources please contact the Keeper and request info be added to this Host Kit. Thanks!

Mitch Teal
The Arc of Oregon
1745 State Street
Salem, OR 97301
1-877-581-2726 Toll Free

Mitch provides a powerpoint presentation on “The Oregon Special Needs Trust”. It is
scheduled typically for a two hour time frame which includes questions and answers.
Equipment needs: Screen (not vital)
Handouts: Mitch will bring packets, but needs to have accurate head-count prior to
training.
Fee: No fee.

DHS - Seniors & People w/Disabilities
Office of Licensing and Quality Care
Attn: (Insert Local Health Support Unit - DD RN’s here)
500 Summer Street NE, #E13
Salem, OR 97301
Anne Christofferson, RN - 503-947-4223
Helen Emmons, RN - 503-947-4229 or 503-731-3088 xt 62 (local)
Helena Haddad, RN - 503-945-9797
DD RN’s have taught “The Fatal Four” in a four and a six hour format. “Medication Admin-
istration” can be done in a two hour format. Specific nurses do classes on Pica and Diabetes.
Equipment needs: Overhead projector, screen for slides.
Handouts: Coordinator is responsible for making handouts, preferably in packet form.
Special needs: A sign in sheet with a category for people to write in what job they
perform.
Fee: No fee.




Jill Foreman
Epilepsy Association of Oregon
619 SW 11th, Suite 225
Portland, OR 97205-2646
503-228-7651
Jill teaches “Brainstorms: Seizure Causes, Effect and Control” in a 2.5 hour or more
                                           X
format. Prefers to do longer, but can do shorter if absolutely necessary.
format. Prefers to do longer, but can do shorter if absolutely necessary.
                                                                                       Page 16
Equipment needs: TV/VCR.
Handouts: Jill will bring packets, but needs accurate headcount prior to class.
Fee: $100.00 for the training.

Miriam Berman
6224 SE Main St.
Portland, OR 97215
503-234-3785

Miriam has a Masters in Deaf Ed. and Special Ed. She teaches Sign Language I,
Sign Language II. She also has a child diagnosed recently with autism and is an
ardent advocate for supports of that group.

OTAC (Oregon Technical Assistance Group)
3886 Beverly Ave. NE, Suite I-21
Salem, OR 97305
503-364-9943 Contact MaryAnn Seaton

“Autism Awareness” and other classes for technical supports. Times vary
as well as equipment needs and prices.

 OIS "Mentor"Trainers (authorized to teach OIS statewide):
current 12/04
John Mushlitz - 503-317-5880
Julie Beaton - 503-481-5172
Mike Larson - 503-788-2731
Carol Dinsmore - 503-262-0158
Toi Gibson -503-655-8558




John Mushlitz, Jr., Consultant
Functional Alternatives
10261 SE Insley
Portland, OR 97266
503-762-5063 (Office)
503-317-5880 (Cell)
Freelance “Oregon Intervention System (OIS)” instructor. This is a two day, fourteen
hour class.
Equipment needs: Wipe board and/or flip chart, markers.
Handouts: John provides handouts, Coordinator will need to make copies.
Fee: $600.00.


Geri Newton, Consultant
P.O. Box 4106
Salem, OR 97302-8106
503-363-6347
Geri does a variety of six hour workshops; “Something Painless for Parents” and
                                          X
“Sexuality and Autism”. Her class are 6 hours from 9 to 4 and 1 hour break for lunch.
“Sexuality and Autism”. Her class are 6 hours from 9 to 4 and 1 hour break for lunch. 17
                                                                                    Page
Equipment needs: Depends on class. Usually just a wipe board, markers and some-
times an overhead.
Special needs: Prefers Fridays for training if possible.
Handouts: Coordinator is responsible.
Fee: About $750.00 - $800.00 for six hour workshop.

Lisa Lieberman, MSW, LCSW
15100 SW Boones Ferry Rd., Suite 750
Lake Oswego, OR 97035
503-697-5956
Lisa does counseling and psychotherapy. She has a son with autism and a husband
with MS. She does a two and a quarter hour forum entitled “My Child is Different and
Sometimes It Hurts…” for parents. She also does couples counseling mostly to support
parents and siblings of autistic children, “Living with Disability in the Family”. Also adults
with autism. Classes are 2 to 2.5 hours.
Equipment needs: Mostly does powerpoint (depending on topic) so needs projector.
Also does overhead in some cases.
Handouts: Coordinator is responsible. Please get updated versions.
Special needs: Needs help with scheduling. Likes to know who audience is, and if
possible, what types of disability their children are experiencing. She likes copies
of the flyer advertising the class as she also does marketing for the class.
Fee: About $100.00. an hour depending on topic.

Kori Brooks
6894 SE Fern Ave.
Portland, OR 97206
503-771-3298
dkbrooks@spiritone.com
Kori teaches “Rights of Individuals with Disabilities”, a 3 hour class. She may be available for
other topics too, by negotiation.
Equipment needs: Wipeboard with markers, or large easel with paper, markers and tape.
Handouts: She will furnish information to coordinator who will make copies.
Fees: $20.00 per teaching hour ($60.00 per 3 hour class).




Mike Larson, Consultant
503-788-2731
David Langlois - 503-422-8203
Jane Rake - 503-493-9383
Mike provides “Autism 1” amd “Autism 2”. Times vary. Autism 1 is a half-day class,
Autism 2 is a full day with a limited number admitted. Dave & Mike co-wrote and teach
"Understanding Behavior" to equal the former Behavior 2. Both are OIS trainers.
Jane is an autism/Aspberger’s Syndrome specialist and often cooperates in training
Autism 2 course.
Equipment needs: Wipe board, markers.
Handouts: Mike brings handouts.
Fee: Varies according to time. About $75.00 an hour.

Tony Farrenkopf, PH.D.                      X
Tony Farrenkopf, PH.D.                                                                Page 18
Clinical Psychology
2256 NW Pettygrove
Portland, OR 97210
503-225-0498 / Fax 503-225-0499
Clinical and Forensic Psychologist for 27 years. Most important classes he likes
to teach are “Victimization Prevention and Abuse Survival and Recovery” (for victims)
which is a combo class), “Sexual Abuse Prevention” (for abusers), “Victimization
Prevention” (for victims), “Abuse Survival and Recovery”, and “Burnout Prevention
Vicarious Traumatization” (for staff). Classes: 1/2 day is 3 to 3.5hr workshop which
includes question/answer time and a 15 minute break.
Equipment needs: Wipeboard or Flip board with markers.
Handouts: He will provide original info and host coordinator will make copies.
Special needs: He likes Fridays, either a.m or p.m.
Fees: $390.00 for 3 hour class, $450.00 for 3.5 hour class.




Steve Smith, Attorney
Smith & McDonald LLP
1100 SW 6th Ave., Suite 1504
Portland, OR 97204
503-248-9535
Steve provides “Wills, Trusts, and Guardianships”, typically two hour formatted,
but with allowance for some overtime if lots of questions.
Equipment needs: Wipe boards and markers.
Handouts: Steve brings, but needs an updated number as well as who audience
is comprised of.
Fee: No fee.

Meg Nightingale
5416 SW Matha Terrace
Portland, OR 97201
503-768-3903

Meg does a variety of different half-day workshops such as “Guardianship and
Alternatives to Guardianship”, “ADA” and “Conflict Resolution”.
Equipment needs: Wipe board, varies upon topic.
Handouts: Coordinator is responsible.
Fee: Roughly $150.00 an hour.

Lori Thompson, Consultant
Specialized Consultation Services
P.O. Box 42658
Portland, OR 97242
503-232-2176
Lori has a variety of topics including Fetal Alcohol Syndrome, Prader-Willis, Pica, Dual
Diagnosis, Learned Helplessness and The X     Humanization Principle, a popular class is
about aging issues in relation to Down’s Syndrome.
Diagnosis, Learned Helplessness and The Humanization Principle, a popular class is
about aging issues in relation to Down’s Syndrome.                                Page 19

Equipment needs: Check with Lori.
Handouts: Coordinator is responsible.
Special needs: Advanced scheduling, follow-up and confirmation.
Fee: Was $400.00 half day, $700.00 full day, $70 per hour.




Robin Wiggin
Region 1 Crisis Diversion Office
4850 SW Scholls Ferry Rd., Suite 104
Portland, OR 97225
503-988-3703 xt 222
Robin provides “Introduction to Developmental Disabilities” in a four or six hour format,
sometimes with teaching partners. Basic Money Management is a 4-hour format.
Equipment needs: Overhead, TV/VCR (for Intro).
Handouts: Robin can usually bring packets copied, but will need to charge 5cents/side for that,
or host can make copies from advance original.
Special needs for Intro: Table in front with chairs, wall space for hanging posters.
Fee: No fee.

Julie Snook, Consultant
7642 SE Flavel
Portland, OR 97206
503-756-4006
Julie provides several workshops, most related to advanced behavior supports
such as “Intermediate Behavior Strategies” (“Behavior 2”) and “Advanced Behavior
Strategies” (“Behavior 3”. Also “Real Work for People with Challenging Behaviors”.
Equipment needs: Usually an overhead, wipe board, but sometimes other needs.
Handouts: Coordinator is responsible.
Fee: $450.00 per day.

Robin Rose, Consultant
2745 105th Ave. NE
Salem, OR 97301
503-873-3649
RKRose@worldnet.att.net
Robin provides six hour workshops on various topics relating to working with
people, having positive attitudes, learning stress management techniques, etc.
Very popular speaker.
Equipment needs: Overhead, flip chart, markers.
Handouts: Coordinator is responsible.
Fee: About $1,200.00 for six hour lecture.




                                           X
                                                                                  Page 20
Nyla McCarthy, Training Program Manager
Office of Investigations and Training (DHS)
2575 Bittern St. NE
P.O. Box 14250
Salem, OR 97309
503-947-4221 Nyla.A.McCarthy@state.or.us

Nyla offers “Protective Services/Mandatory Abuse Reporting” classes, as well as
“Conflict Management”. These are typically 2 - 3 hour formats.
Equipment needs: Overhead, wipe board, markers.
Handouts: Ask Nyla.
Fee: No fee.

Tom Zaner
Protective Services
998 Library Ct.
Oregon City, OR 97045
503-723-4868
Tom provides an “Understanding Protective Services and Required Reporting”
class, about an hour and a half in length.
Equipment needs: None.
Handouts: Tom provides.
Fee: No fee.

Lee Greer, Consultant
503-239-8569 No Voice Mail. Prefers E-mail
leegreer@fastmail.fm
Lee offers several different classes, among them “The Ethics of Touch”, a six hour
seminar based on video tapes of Dave Hingsburger; “Behavior 1”, a four hour class, and a
class on Parole and Probation and the Criminal Justice System, and Basic Behavior
Equipment needs: Depends on the topic, typically a wipe board, markers, room big enough for
small groups.
Handouts: Coordinator is responsible.
Class Size: Prefers 12-20
Fee: Typically about $75.00 an hour. Also charges extra for out of PDX area or preparing a
new class.




Diane Malbin
FASCETS
Fetal Alcohol Syn. Consultation, Education
and Training Svcs, Inc.
15500 NW Ferry Road, #L - Address needs verification
Portland, OR 97231-1331
503-621-1271 or cell 503-888-2107

Diane instructs on “Understanding Fetal Alcohol Syndrome”. While this can be
presented in a three hour format, it is highly recommended to have her do a longer
presentation. High audience response.
                                              X
Equipment needs: Overhead, overhead transparency sheets, overhead markers, slide
Equipment needs: Overhead, overhead transparency sheets, overhead markers, slide
                                                                               Page 21
projector and screen, TV/VCR and wipe board.
Handouts: Coordinator makes the copies.
Fee: About $1,500.00 for a six hour seminar.

Tammy Bradley
Regional Assistant
Oregon Parent Training and Information Center
1745 State St.
Salem, OR 97301
1-888-505-2673
503-642-0226 - Tammy’s Local Number
Tammy presents two hour (with extra time for overlap) workshops on various topics
related to education for children with disabilities; “IEP”, “Transition” and “Transition
to Kindergarten”, etc.
Equipment needs: Tammy brings a powerpoint presentation.
Handouts: Tammy will bring, or for collaboration, coordinator can offer to help.
Fee: No fee.

Lori LeDuc
Washington County DD
503-846-5750
Teaches “Disability Awareness”.
Fee: None.

Jami Cloghessy
10660 SW Dazies, #42
Beaverton, OR 97008
503-372-5886
Specializes in conflict resolution, communication. Teaches "Clients are Easy, Staff is What's
Hard", a 2-3 hour course.
Fee: $35.00 an hour.

Mike Malchow-Hay
4026 NE 39th
Portland, OR 97212
503-281-3634
Teaches on "Medical Record Keeping". Long time Rainbow Adult Living staff member.

Steve Tate, RN
Coast Rehab -
503-491-5005 xt 103
Former instructor for Fatal Four when was RN for State DD.

Burton Silverman, psychiatrist
503-644-1171
Teaches on "Psychotropic Drugs".




                                             X
503-644-1171
                                                                                          Page 22
Teaches on "Psychotropic Drugs".
Cost unkown.

Val Valrejean, MSW, CADCII
2921 NE Maplewood Drive
Vancouver WA 98665
Cell is 503-309-8704
Wk is 503-226-2203

She teaches classes on:
leading psychosocial groups (train the trainer or anything on the topic), mood management,
anger & stress management, positive social skills, relationship skills, differentiating psychiatric
symptoms from obnoxious behavior, management of emotional dysregulation, and alcohol &
drug addiction among people with DD




Jerry Annand
Annand Counseling
1815 SW Marlow Avenue
Portland OR 97225
503-297-4363

Specializes in substance abuse & addiction topics. Has worked extensively with people with DD.


***If you have any corrections or new information on the listed instructors
and their classes, please contact the Host Kit Keeper so the records can
be updated for everyone!




                                              X
                                                       REGION 1 DD TRAINING CO-OP
                                                            Site Location Options*


            Name of Location                    Address                         Phone                 Contact           FEE                Additional Info

ADS -                             2900 SE Division
Aging and Disabilities Services   Portland, OR
American Red Cross


American State Bank               2737 NE MLK Jr. Blvd.                     503-282-2216
                                  Portland, OR 97212
Beaverton Library                 12375 SW 5th, Mtg. Rm. B                                                                    *contact Jerri Rudacil to receive
                                                                                                                              registration directions
Clatsop County -
Community Center
Columbia River P.U.D.             Deer Island - Hwy 30


DSI -                             305 NE 102nd, Ste.100                     503-258-2440       Jody Michaelson                Meeting room holds 25 people.
Developmental Systems, Inc.       Portland
Eastco Diversified Services       PO Box 470                                503-667-0613       Susan Norman
                                  Gresham, OR 97030
Goodwill


Hillsboro -
Public Service Bldg.
Kaiser Permanente -               3704 N. Interstate Ave.                   503-280-2995       Public Relations               Need to be authorized to use it.
Town Hall                         Portland, OR 97227
Legacy Emmanuel Hospital                                                    503-413-2200       Room Scheduling          Yes   Must apply each time to use. No fee
                                                                                               Ron or Kristin                 for non-profits.
Legacy Meridian Park Hospital -   19300 SW 65th                             503-335-3500
Hospital Community Ed. Center     Tualatin, OR 97062



                                         *   If you have more current info on any sites please send it to Host Kit Keeper                                  Page 23
                                                        REGION 1 DD TRAINING CO-OP
                                                             Site Location Options*


         Name of Location                        Address                         Phone                 Contact           FEE                   Additional Info
McMenamins / Edgefield             2126 SW Halsey                            503-669-8610
                                   Troutdale, OR
McMenamins / Kennedy School        5736 NE 33rd                              503-288-3286       Owen Craig               Yes      You need to fill out non-profit application
                                   Portland, OR 97211                        503-288-6559 fax   Event Coordinator                 and provide a mission statement to get
                                   owenc@ks.mcmenamin.com                                                                         fee waivered.
Mt. Scott Park -                   5512 SE 73rd                                                                                   Cost but nice facility w/ several options.
Presbyterian Church                Portland, OR
Multnomah County Bldg              Grand and Hawthorne                       503-988-3701                                         pay to park across street or bus 14.


Multnomah County -                 805 SE 122nd St.                          503-988-5392                                    ?    4 blocks S. of Burnside, near the MAX
Midland Library                    Portland, OR 97233
Mult. Co. Sheriffs -               122nd & Glisan                                                                                 Holds LOTS but lacks chairs.
Hansen Center                                                                                                                     No equipt & only water is bathrooms.
New Hope Community Church          11731 SE Stevens Rd.                      503-659-5683       Gary Cowles                       Off 205 & Sunnyside in Clackamas
                                   Portland, OR 97266
Oddfellows -                       39th & Hawthorne                          503-231-1411


Police Precinct -                                                                                                                 St. John's City Hall Building
North
Police Precinct -                  449 NE Emerson                          503-823-5700                                           Have a great-room, coffeepot.
Northeast                          Portland, OR 97211                                                                             (Killingsworth & Martin Luther King)
Police Precinct -                  727 SE 106th                              503-823-4804                                         Has community room available.
East                               (Off 205, Wash/Stark)                                                                          Seats 50-55 max. Coffeepot, TV, screen.
Region 1 Crisis Diversion Office   4850 SW Scholls Ferry Rd., #104           503-988-3703       Jeannie                      No   Conf. Rm. Holds about 15-20.
                                   Portland, OR 97225                           xt 221                                            Overhead, TV/VCR, coffeepot.
Sunset Presbyterian Church
United Way -                       619 SW 11th                               503-228-9131



                                          *   If you have more current info on any sites please send it to Host Kit Keeper                                        Page 24
                                                          REGION 1 DD TRAINING CO-OP
                                                               Site Location Options*


         Name of Location                          Address                         Phone                 Contact           FEE               Additional Info
                                      Portland, OR 97205
Willamette Falls Health & Ed. Cntr    519 15th St.                             503-657-6919                                      Rm can hold 48 / open for double amt.
Community Ed. Bldg.                   Oregon City, OR 97045                                                                      Also have Auditorium
Wilshire United Methodist            3917 NE Shaver                          503-282-6431         Helen Stewart                  Off Fremont & NE 39th. Free Parking.
                                      Portland, OR 97212                                                                         Closest bus is #75 at 42nd & Shaver.
                                                                                                                                 Predominately Native American church
                                                                                                                                 who reaches out to disabled and deaf
                                                                                                                                 community




                                            *   If you have more current info on any sites please send it to Host Kit Keeper                                Page 25
                             Hosting Agency
          as part of the Region 1 DD Training Co-op offers:


         NAME OF TRAINING
                Name of Speaker, Title, Agency
                         Day, Date:
                           Time:
                         Location:
                     Location Address:

       Cost per registrant (Co-Op member rate)*:
* Foster care & families always get member rate but rate DOUBLES if registrant is not
                        affiliated with a Co-Op Member/agency)




                Course Description & info about class


    Contact Name and E-mail address for any questions.


      Additional Information available at http://sdri-pdx.org/training/co-op
  ---------------------------------------------------------------------------------
                REGISTRATION AND PAYMENT FORM for (class name & Date)

   _______________________________________________
         Name                      Phone Number                              E-mail

   _______________________________________________
    Agency Name         AFH? Y or N               Mailing Address     City           State Zip

            Region I Training Co-op Member? Y or N (fee is double for non-members)
               Amount Enclosed $________ payable to (agency name & address)
                                       REGION 1 DD TRAINING CO-OP ROSTER


       Host Agency                                                                           Course Title

                                               Bold = No Shows
   Class Instructor                            Italics = Walk-Ins

                       Please PRINT your information below next to your name                                       Date

                                               FOSTE PAID
          NAME              AFFILIATION        R HOME               PHONE      WORK E-MAIL       WORK ADDRESS      COUNTY
                                                      ?
                                                  ?


AGENCY FILLS OUT                                       Agency
REGISTERED STUDENTS                                    Fills Out
HERE




    Revised 7/8/2010                                                                                            Page 27
                                   REGION 1 DD TRAINING CO-OP ROSTER


 Host Agency                                                                             Course Title

                                           Bold = No Shows
Class Instructor                           Italics = Walk-Ins

                   Please PRINT your information below next to your name                                       Date

                                           FOSTE PAID
     NAME               AFFILIATION        R HOME               PHONE      WORK E-MAIL       WORK ADDRESS      COUNTY
                                                  ?
                                              ?




Revised 7/8/2010                                                                                            Page 28
                                   REGION 1 DD TRAINING CO-OP ROSTER


 Host Agency                                                                             Course Title

                                           Bold = No Shows
Class Instructor                           Italics = Walk-Ins

                   Please PRINT your information below next to your name                                       Date

                                           FOSTE PAID
     NAME               AFFILIATION        R HOME               PHONE      WORK E-MAIL       WORK ADDRESS      COUNTY
                                                  ?
                                              ?




Revised 7/8/2010                                                                                            Page 29
                                   REGION 1 DD TRAINING CO-OP ROSTER


 Host Agency                                                                             Course Title

                                           Bold = No Shows
Class Instructor                           Italics = Walk-Ins

                   Please PRINT your information below next to your name                                       Date

                                           FOSTE PAID
     NAME               AFFILIATION        R HOME               PHONE      WORK E-MAIL       WORK ADDRESS      COUNTY
                                                  ?
                                              ?




Revised 7/8/2010                                                                                            Page 30
                                   REGION 1 DD TRAINING CO-OP ROSTER


 Host Agency                                                                             Course Title

                                           Bold = No Shows
Class Instructor                           Italics = Walk-Ins

                   Please PRINT your information below next to your name                                       Date

                                           FOSTE PAID
     NAME               AFFILIATION        R HOME               PHONE      WORK E-MAIL       WORK ADDRESS      COUNTY
                                                  ?
                                              ?




Revised 7/8/2010                                                                                            Page 31
                                    COMPLETION REPORT
                       (After hosting a Region 1 Training Co-op Class)



Please fill in blanks.                                            Host Agency

                                             DATE OF
             CLASS TITLE                                         INSTRUCTOR(S)
                                              CLASS

              Title Here                                          Names Here

                                             TOTAL #     TOTAL # of Co-Op Attendees
     TOTAL # of ATTENDEES
                                          of NO SHOWS     (not from your own agency)


                 # Here                       # Here                  # Here

                                          FEE AMT PER
TOTAL # of LATE REGISTERS                             TOTAL FEES COLLECTED               ($)
                                          STUDENT ($)

                 # Here                    Amt $ Here              Amt $ Here

Direct expenses: _________
(including instructor fees, site fees &
refreshments)


___________# of Hours used hosting, scheduling, coordination, registration, class
preparation, certificate preparation, class itself, clean-up, etc. (Please estimate an
actual number of hours even if you're not sure or another person was helping)

Comments for future training:




Please attach a copy of the original roster indicating who registered in advance,
walked in, and the agency and/or Foster/Group home each student is affiliated with.
Send this Completion Report, copies of any handouts and attachments to the
Keeper within 2 weeks to one of the following:

Paula Kerns, Keeper
520 SE 29th Ave                           E-mail:       pjkerns@msn.com
Portland, OR 97214                        Phone:        503-232-0394



                                          Thank you!



                                                                                               7/8/2010
                                                Region 1 - DD Training Co-Op
                                                                      Evaluation
Host Agency: __________________________                                                                                                      Date: ________

Instructor's Name: ______________________                                                             Title of Training: _________________________


Using the scale at right, mark an "X" to rate   Strongly                                  Strongly   If you marked "Disagree" or "Strongly Disagree", please tell
                                                           Disagree   Unsure     Agree
the class content and trainers.                 Disagree                                   Agree     us what the problem was.

This material will be useful to me.

The handouts, visual aids, and class
activities were useful.
The amount and level of information was
about right for me.

The speed and pace was about right.

I learned what I wanted or needed to learn.

The trainer(s) organized the presentation
well.
The trainer(s) exhibited very good
knowledge of the subject.
The trainer(s) were clear and easy to
understand.

I will recommend this class to others.




Please circle your overall rating of the
                                                Terrible    Poor       Fair    Very Good Excellent
training.
Please circle your overall rating of the
                                                Terrible    Poor       Fair    Very Good Excellent
trainer(s).



Comments or feedback:




                                                                                                                                                 Revised 7/8/2010
            Type Name Here
                                has
                            Completed

                   Title of Training Here
                              on
                        Date Here , 2004
                   From “what time to what time”
                                at
                       Name of training site



HOST AGENCY HERE                                HOST CONTACT NAME HERE

                         INSTRUCTOR NAME HERE

				
DOCUMENT INFO
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