Workshop Request Form
Name *
Your answer
School/Organization *
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Email address *
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Contact Number *
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Workshop Address *
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How did you hear about our organization? *
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Workshop Topic(s) *
Check all that apply.
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Workshop Date & Time *
If requesting a workshop series, select the series start date.
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Time
:
Workshop Demographics *
Who is this workshop for? Fifteen 7th graders? Ten out of school youth? Thirteen parents? Tell us about the group you are interested in having us with with.
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