InJewel HSF Action Lab Registration
Thank you for your interest in becoming a member of InJewel's HSF Action Lab! To ensure members of the group meet the group's requirements, please fill out the form below. We will review your responses and get back to you within 1-3 business days to confirm your eligibility. If you are eligible, you will receive a request for payment in the amount of $149.97. Receipt of payment secures your spot in the group.
Email address *
First and Last Name *
Your answer
Stress Address *
Your answer
City, State, Zip *
Your answer
Phone Number *
Your answer
Describe your level of academic or other training in the field of behavior analysis, including certification(s). *
Your answer
Describe any training outside the field of behavior analysis, including certification(s). *
Your answer
Why do you want to be a member of InJewel's HSF Action Lab? What do you hope to achieve over the next 3 months? *
Your answer
What are your expectations for the InJewel's HSF Action Lab? What do you expect to get from Julie and other members of the group? *
Your answer
Please confirm that you understand that the HSF Action Lab is not about (1) being told what to do, (2) being critical of each other, (3) knowing the answer, or (4) mentoring. *
Required
Please confirm that you are able to submit a one-time payment of $149.97 upon acceptance into the HSF Action Lab. *
What questions, if any, do you have for Julie?
Your answer
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