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WORKSHOP/ SPEAKING REQUEST
Businesses, non-profits and other organizations who would like to discuss fees and availability, please complete the form. Someone from KPCC will contact you to discuss event details.
Contact
kathy@kpcc.com
with questions.
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Which type of workshop are you interested in hosting?
*
ADHD
Anger Management
Autism Awareness
Communication and Team Building
Couples and Relationships
Critical Incident/Stress Management
Ecotherapy
Infertility and Pregnancy Loss
Individual Consultation
Mindfulness for Pain Management
Mindfulness for Stress Relief
Motivational Interviewing: Why Nagging Doesn't Work
Nonviolent Communication
Parenting and Boudaries
Perinatal Mental Health
Schema Therapy
Setting and Keeping Boundaries
Understanding Your Loved One's Addiction (for parents, partners, and families)
Zentangle
Other:
Would you like KPCC to provide CE credits for this workshop? (SW, LPC, RN & Addictions)
*
Yes
No
Maybe
Which of the following do you represent?
*
Congregation or Clergy
Business
Government Agency
Non-profit Organization
School or University
Other:
Where will this event take place?
*
Business
Church
Community Center
School
Other:
Preferred Date for Workshop
MM
/
DD
Alternate Date for Workshop
MM
/
DD
Will this event be open to the public?
*
Yes
No, this will be a private event
Required
How many participants do you expect to attend this workshop?
*
Choose
1-10
11-20
21-30
30 +
Unsure
First and Last Name
*
Your answer
Email Address
*
Your answer
Phone Number
*
Your answer
Sponsoring Agency
*
Your answer
Comments or Questions
Your answer
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