Youth Programs Workshop Request Form
Thank you for your interest in collaborating Youth Programs at Neighbors In Action (NIA).

Please fill out the form below to give us more information about your group and what you're hoping to gain from one of our workshops and introducing your group to our work. Provide us with as much information as possible.

Name of School or Organization *
Your answer
Group Name or Class *
Your answer
Address of School or Organization *
Your answer
Mission or Group's Focus *
Your answer
Name of Contact Person *
Your answer
Phone number *
Your answer
Email Address *
Your answer
How did you hear about us?
Your answer
Please check off your requested workshop: *
Required
Please tell us more about the group you'd like us to work with including general demographics, ages, size, and any potential strengths or challenges. Why would you like to bring NIA Youth Programs to this group? *
Your answer
What is your location? Please note if you would prefer coming to our office at 256 Kingston Ave in Brooklyn, NY. *
Your answer
What are the hours and potential dates for the visit? *
Your answer
Please check off any resources that your organization can provide: *
Required
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