TEEN LEADERS WORKSHOP REQUEST CONTACT INFORMATION Contact Name * First Name Last Name Contact Title * Contact Email * Phone * (###) ### #### COMPANY INFORMATION Company/Organization Name Organization Address * Address 1 Address 2 City State/Province Zip/Postal Code Country SIGNATURE WORKSHOPS Event Type * In-Person Virtual Recorded Workshop Budget * Under $1,000 $1,000 - $2,500 $2,500 - $5,000 $5,000 - $10,000 $10,000 - $20,000 Over $20,000 Workshop Options * Which workshop would you or your organization like to host? LEAD WELL - Foundational Leadership and Personal Growth GET IT DONE - Goal setting & Personal Organization SHOW UP - Personal Branding GO! GET INSPIRED - Identity & Personal Values REAL TALK - Conflict Resolution & Critical Conversations ART & ACTIVISM - Spoken Word Poetry & Storytelling SPEAK UP - Public Speaking CHANGE AGENTS - Social Responsibility WRITE NOW - Creative Writing YOU GOT THIS - Mindfulness + Stress Management THE METAVERSE - Navigating Digital Relationships: Healthy Connections Online BOUNCE BACK - Building Resilience Customized Workshop Experience Are you interested in a customized workshop experience? Please provide your learning outcomes. ACCOMMODATIONS Event Venue Name Event Venue Address DATES & TIMES Proposed Date * MM DD YYYY Proposed Start Time * Hour Minute Second AM PM ADDITIONAL INFORMATION Product Table | Promotional Material * May we set up a promotional/product table at your event? Yes No Video Recording | Photography * Are we allowed to take pictures or record video images at your event? Yes No Additional Information If you have multiple dates and times for your event please add that information here. After you click "SUBMIT," you will be redirected to our next steps page. Please follow the prompts to schedule a follow-up conversation regarding your request. Thank you. Here’s Your Next Step.