ORDER FORM: Brick City Mindfulness Handbook
The current intention of this handbook is to help constituents, families, and individuals in Newark address ongoing basic needs during the pandemic. For Newark Center for Meditative Culture (NCMC), that means to support mental health, stress-reduction, and well-being.
This handbook is basic and for beginners in the practice of mindfulness and meditation. With each handbook you will also receive a Mental Health Quick Guide Flyer. You can insert it into the handbook or distribute or post it as you prefer. Scroll all the way down to see an image of the front of the Flyer. (The back of the flyer contains a couple links to NCMC practices for stress-reduction and well-being.)
NCMC representatives are available, for those organizations and groups who have a budget, to provide a beginners workshop or series using the handbook. If you would like to discuss a potential NCMC led workshop beforehand, contact Ib’nallah S. Kazi at
or you will be contacted once you have filled out the Order Form.
The Brick City Mindfulness Handbook is available September 1st, 2021.
REQUIREMENTS FOR ORDERING:
1. Location: Must be a Newark NJ organization or group (even informal) working with residents/families of and/or employees in Newark.
2. Distribution: Please distribute one per individual or family or whatever suits the needs.
3. Quantity to order: Please order just what you need. We ask that you order what you feel the real quantity is that will be used and distributed and order more if supplies are still available. Maximum quantity per order is 100.
4. Pick-up: Our plan is to arrange specific pick-up times that may be convenient to you at our location at 2 Park Place.
5. Recipient Survey: We ask that you request that the recipients of the handbook take the Recipient Survey after they have read it or used it in a workshop. We understand that some may not be willing to do so, but it will help us in further understanding the needs and interests of the Newark Community and in making any revisions to the handbook for any subsequent printings. Recipient Survey can be found at
6. Organizer Survey: We also request if able that any organization or group who distributes or utilizes this handbook also fill out a simple survey after the distribution or use of the handbook, based on your own perceptions as well as any feedback given. Organizer Survey can be found at
Please contact us if you have questions or need help with any of the material in the Handbook at
Sign in to Google
to save your progress.
Contact Full Name
Organization or Group Name
Organization/Group Full Address
Your intended purpose for use of Handbook (Examples: General distribution; young adult workshops; family mindfulness sessions; given as a gift as part of a program; use as a learning tool in gatherings, etc.)
Quantity required (maximum 100 copies)
Date needed (if any)
If you have a budget, would you like us to contact you about the possibility of an NCMC representative providing a beginners workshop or series using the Handbook?
We will contact you to arrange the pick-up the handbooks, thank you. SUBMIT BUTTON TO ORDER BELOW.
Mental Health Quick Guide Flyer (front): The back of flyer contains links to free NCMC basic programs.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service