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Workshop Request Form
Please complete the following questions to the best of your ability.

If a question is not applicable to your workshop or you do not have an answer at this time, please leave the field blank.

If you have any questions or concerns, please feel free to email our SafeSpace Education Coordinator at

Contact Person Name and Pronouns *
Pronouns refer to how you would like others to refer to you in the third person (i.e., she/her, he/him, they/them, etc.)
Your answer
Contact Phone Number
Your answer
Contact Email Address *
Your answer
Name of Organization or Entity
Your answer
What should a facilitator know about the culture of your organization or entity?
This helps our staff prepare more to partner with your specific organization.
Your answer
What are you most hoping attendees will gain from this workshop? *
Your answer
What knowledge related to the workshop do you anticipate attendees will already have?
Your answer
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