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Presentation & Workshop Request
Name
(Required)
School/Organization
(Required)
Position/Role
Email
(Required)
Phone
(Required)
Program Requested
(Required)
School presentation
Support group program
Self-defense workshop
Parent workshop
Estimated number of students/participants
(Required)
Preferred Dates
Message/Additional Details
(Required)
Consent
I understand that a confirmation email will be sent after availability is reviewed.
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