Speaker Request Form

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If you would like a mental health presentation at your school or organization, please complete the request form below and we will respond with our availability and information about fees, equipment, etc. Thank you for your interest. We look forward to communicating with you.

Number of Sessions Requested *

Date(s) of Service Requested *

Time(s) of Service Requested *

Type of Service *

Parent Workshop

Teacher Training/Professional Development

Classroom Workshop

Community Workshop

Peace/Talking Circle

Required

Topic *

Children's mental health

Parent-child communication

Family conflict

Managing transitions

Parenting in the digital age (managing social media)

Healthy relationships

Youth suicide awareness

Trauma in youth

Building resilience in youth

Early-child development

Early-child school readiness

Trauma-informed care

Supporting Social-Emotional development

Reducing risk of violence involvement

Supporting New Neighbor Families

Required

If you chose 'Other,' please explain below:

Language Needs *

English

Spanish

Both

Other:

Required

Equipment Needs

Name of Organization/School *

Primary Contact Name *

Position/Title *

Primary Contact Email *

Submit

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