The Icarus Project Workshop Request
Email address
First Name
Your answer
Last Name
Your answer
Location (City, State)
Your answer
Phone Number
Your answer
Organization / School
Your answer
What are the requested dates? (can be a specific date & time, or a general time frame)
Your answer
If an organization is hosting, what is the mission of your organization?
Your answer
Organizational website or social media page
Your answer
Which workshop are you interested in hosting?
Click here for a description of each workshop offering: http://theicarusproject.net/for-peers/ - and for professional care providers: http://theicarusproject.net/providers/
How many participants do you anticipate attending?
Your answer
Tell us about who will be participating and their identities and background.
Your answer
Do you have any specific requests for the identity and background of the facilitator? (LGBQ, trans/non-binary, POC, community organizing background, etc)
Your answer
What budget do you have available to host The Icarus Project?
Icarus Project workshops are offered on a sliding scale rate, with the requested amount starting at $600, inclusive of materials. Additional funding may be requested based on facilitator travel requirements. If you do not have a budget, that's ok, just indicate what your organization can provide in terms of support, no matter how small! Please note: depending on organizational capacity, we may not be able to meet all requests for free or low budget requests.
Your answer
Are you willing to host us through a webinar if schedule or costs prohibit an in-person facilitator?
Would this workshop be part of a larger program? (conference, retreat, training, series, etc.)
If this will be part of a larger program, please describe the program
Your answer
Any other questions or things we should know?
Your answer
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms