Impact that Stands Up - Expression of interest in future workshops

Request edit access

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

We understand that the current workshop timing or location may not suit everyone. This form allows us to better understand demand and tailor future sessions to meet your needs, including potential online options.

We’ll be in touch with updates about upcoming workshops. Registering your interest does not commit you to attend.

Name

Email address

Which option best describes your interest?

Online workshop

In-person workshop at another location

Either, depending on timing

Clear selection

If you selected 'in person workshop at another location', please specify where (e.g., city, region) would you like it to be?

What is your role?

Health promotion / prevention practitioner or manager

Population health / community development practitioner or manager

Human services practitioner or manager

Place-based program practitioner or manager

Other:

Clear selection

Would you like to subscribe to our newsletter?

Yes

Clear selection

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Forms