Inquiry & Initial Intake Form: Youth Passageways' Education and Consulting Collective
Thank you for your interest. Please take a few minutes to fill out this form, and someone will be in touch with you shortly. If you have any questions, you can email ecc@youthpassageways.org
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Name *
Email *
Phone Number
Organization or Affiliation (if any)
Gender Pronouns
Racial Identity
Do you have any accessibility needs?
Geographic location
Are there any other aspects of your identity that you wish to share?
What is your relationship with Youth Passageways?
What sort of services are you seeking?
Is there a particular member of our team you are reaching out to connect with?
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What hopes, goals, challenges, or other topics are bringing you and/or your group or organization to make this inquiry?
What question(s) are on your heart right now, related to this inquiry?
What, if any, vision do you hold of specific outcomes or desired results from our work together?
How do you most like to be supported? What learning styles come most naturally for you, and what are most challenging? If writing on behalf of a group or organization, please comment on important practices and aspects of culture embedded in the group.
Is there anything else you wish to share?
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