Building Up! Field Partner Form
Thank you for helping us get our new, game-changing FASD workshop on the road! We really believe that this is the most practical workshop available, and so we want many families and professionals to see it!

If you haven't already, please check out the workshop's website at so that you can get an idea of what to expect. Please note that this is NOT just a workshop, but it also includes an extensive, individualized list of recommendations that families can take home and share with other caregivers. Professionals who attend get a similar document and benefits as well.

This form will gather your information and give you an idea of what we need. We will be contacting you by the end of the summer as we begin to set the schedule for the rest of 2018 and 2019 workshops.

Your name
Your answer
Your email address:
Your answer
Your phone number:
Your answer
You are a:
Where is the area you live/can help us organize a workshop? (Cities, States/Province)
Your answer
Which of the following can you help us with?
Your answer
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