Workshop Request Form

School (required)

Contact Person's Name (required)

Work Phone Number

Email (required)

Personal Phone Number

*The personal phone number will only be used if we need to get a hold of you immediately and you are not available at your work phone.

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Areas of Interest
 Body Image  Leadership  Healthy Relationships   Communication  Parent Workshops

Please check our workshops calendar - here.

We are only able to offer two workshops per day.


1st Choice

Date

Time

2nd Choice

Date

Time

Attendance and Selection Process:
Please list the number of girls expected to attend, their grade level, and how you will choose the group of girls who will participate in the workshop.

Program space: Please describe the space in which your workshop will take place. Is there a white or chalk board available? Desks or tables?

Is there anything you would like us to know about your school/program’s environment? Are there particular issues girls are facing that you would like for us to address? Anything else we should know?

By submitting this workshop reservation form, you agree to:

• Provide a private space for the workshop (like a classroom)
• Recruit a minimum of 10 girls
• Communicate schedule changes to a confirmed workshop at least one week in advance