Power On Workshop Request Form
Thank you for your interest in a Workshop from Power On! Please enter the details of your desired workshop below.

Before completing our form, please note the following request guidelines:

* Each Module lasts for approximately 1 hour.We request a minimum of 2 weeks advanced notice for all institutions based in the Southern Californian Area and a minimum of 1 month advanced notice for all other locations. 

* We request a minimum of 12 and recommend a maximum of 24 participants. 

Email address *
How would you like the workshop to be delivered? *
WORKSHOP INFORMATION
Which Workshop Are you Requesting? *
Required
Workshop Date *
On which date (MM/DD/YY) would you like the workshop to take place? If dates are flexible, please describe options.
Your answer
Where would you like your workshop to be held? *
Please include your address
Your answer
How many participants do you anticipate? *
Your answer
What do you want participants to take away from this workshop? *
Your answer
CONTACT INFORMATION
Email *
Your answer
Name of School or Organisation *
Your answer
Would you like to join Power On's Mailing List? *
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