Three-Session Series Interest Form

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Thank you for your interest in this series. It is planned to start the week after Easter and will run for three weeks, most likely the same day of the week and same time of day. Each session is planned for 90 minutes. Please complete this interest form and submit as soon as possible. It would be best to get responses by March 1, 2022.

Name *

Best Email *

Best Phone *

1) Why are you interested in participating in this series? *

2a) If you participated in this series, would you need child care? *

Yes

2b) If you answered yes to the previous question, how many children would you need care for and what ages are they?

3) What days and times of day would you be able to attend three sessions in a row? Please check ALL that you could attend.

AM (9 am - noon)

Noon (noon - 1:30 pm)

PM (1 pm - 5 pm)

Evenings (6 pm- 8 pm)

Monday

Tuesday

Wednesday

Thursday

Saturday

4) Can you commit to attend all three workshop sessions? *

Yes

5) The first 25 participants who register can receive a $50 stipend per session to defray any expenses incurred. Let us know if you are interested in receiving that stipend.

I would like to get the stipend.

I don't need the stipend and would like it to go to another person.

Clear selection

6) If you have any comments, questions or concerns, please share them here.

Submit

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