Get In Touch

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Get In Touch

Want to explore bringing a FREE expert training session on digital safety & wellness to your school, church, or youth group? Or are you interested in joining a team of passionate advocates and educators?

We'd love to hear from you! Just fill out the short form below and we'll be in touch!

--The Screen Time Clinic x COSMO team

Email *

Your name *

I am interested in: *

Bringing a free training seminar (virtual or in person) to my school, church, or youth group

Learning more about becoming a paid educator on digital safety & wellness

Both!

The group I had in mind to benefit from the presentation: *

High School

Middle School

Elementary School

Youth Group (non-school) in Person

Youth Group (non-school) Online

Parent Group (non-school) in Person

Parent Group (non-school) Online

Other:

Required

I learned about this opportunity *

From Cosmo Email Communications

From Screen Time Clinic Email Communications

Other:

Tell us a little bit about your interest! (e.g. the organization where you'd like to bring a training, preference for virtual or in person, why you're interested in digital wellness education, etc.)

What state & city are you located in? Or would this be virtual? *

Contact info

Please provide your contact info and let us know the best way to reach you so our team can follow up. We can't wait to talk!

E-mail *

Phone number

Preferred contact method *

Phone

Required

Thanks! We'll be in touch soon and can't wait to talk!

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms