Workshop Interest Form
Greetings!  Thank you for considering me to facilitate a workshop for you.  I work on a sliding scale to accommodate all budgets. Once you submit the form, I will be in touch with you via email to discuss details.
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Organization Name
Your full name *
Email address *
Date you are requesting workshop for *
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Theme of workshop you are looking for (If you have a suggestion please use the other box) *
What is the demographic of your group (age, location, gender identity, racial backround) Please also include the size of your group. *
Your budget *
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