Workshop Form — EXPANSIVE HEART CONSULTING

Expansive Heart Consulting

WORKSHOP Inquiry

Welcome! Please take some time to answer the questions as thoroughly as possible. If any of the questions do not apply to you, please answer N/A. All information will remain confidential.

I currently offer workshops that focus on issues related to Social Justice and Equity; Mindfulness; Restorative Justice; Dis/ability and Special Education; issues related to students, faculty and families within the LGBTQIA community; and self care for educators, activists and care-givers at-large.

Name

First Name

Last Name

1) Where do you work? What is your job title?

2) What specific issues are you hoping to address in your workplace?

3) How long have these issues persisted?

4) What resources have you used (people, organizations, books, etc) to address these issues prior to contacting me?

5) What are some strengths of your current workplace?

6) What do you hope to get out of our time together?

7) Contact information: Name/ preferred email address/ phone number organization/ affiliation

Billing and Payment: After I receive your request, I will email you with an estimate based on my full day/ half day rate. Note that I am willing to deliver lectures on honorarium amounts, but knowing an estimate up front helps me to make decisions about time away from work and family to invest in the mission of your organization. Please indicate your available honorarium amount for this workshop in U.S. dollars:

Expansive Heart Consulting

WORKSHOP Inquiry

Schedule Appointment