Unleash Her Inner Confidence Workshop 
Hello!  Thank you for your interesting in bringing Unleash Her Inner Confidence Workshop to your school.  
Please complete this form and a representative will follow up with you. 
We look forward to connecting with you.  

Confident Queen Leadership Team
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Email *
First Name  *
Last Name  *
Title or Position *
Name of School/Organization *
Address *
Phone Number *
School/ Organization Website
Title 1 School?
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Total Student Population
Grade Levels You're Requesting the Workshop for. *
Required
Secondary Point of Contact (First and Last Name)
Secondary Point of Contact Phone Number 
Secondary Point of Contact Email Address  
What type of event are requesting *
Describe your audience/ attendees. *
How many people are expected to attend? *
Estimated Budget *
Event Date(s) of Interest *
Event Time *
Will this event/ session be recorded? *
Does your organization currently have a confidence and/or self-esteem program for girls? *
Is your organization interested in the Confident Queen Journal & Workbook? *
Is there anything else you would like to share about your event? *
A copy of your responses will be emailed to the address you provided.
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