Training/Workshop Request Form
We are excited to review your request. Due to the volume of requests we receive, please expect a 2-week turn around time. If you have not heard from us after 2 weeks, please email: navila@heartwomenandgirls.org
Please carefully read the following statements and indicate below if you agree to them:
The workshop I am requesting is at least three months from now. If it is less than three months from now, I understand that my request may not be accommodated.
I have already spoken with our board and leadership and have the green light for this program to happen. I understand that if this has not happened yet, it can further delay the intended timeline.
I understand that HEART charges modest program fees and travel expenses for their workshops and trainings and we have a budget allocated for this program.
I fully support and appreciate HEART's commitment to staff wellness and am willing to work to plan a program that aligns with their commitment to staff wellness and capacity.
I understand that HEART staff is bringing decades of expertise in program planning and capacity building and am open to hearing their recommendations for a successful program.
I understand that HEART, at its discretion, can choose to not move forward with a partnership if the circumstances compromise their organizational values.
*
In an effort to be transparent, the aforementioned statements are expectations we have for any partnering organizations/groups/individual we do programming with.
- Yes
- No
Please select the description that best matches the organization *
- Mosque and/or place of worship
- Community Center
- Social Services Organization
- Health Center/Clinic
- College Program/Group
- Direct Service Organization
- Legal Aid/Clinic/Business
- Indigenous/Native Organization
- Federal Organization
- Policy Organization
- Reproductive Justice Organization
- Gender Based Violence Organization
- Other
Please note that we require at least 2 months of prior notice to plan and schedule trainings.
Proposed type of program *
- Panel
- Book Talk on The Sex Talk: A Muslim's Guide to Healthy Sex & Relationships
- Workshop (Awareness, Educational)
- Training (Professional Development, Capacity Building)
- Keynote presentation
- Webinar
- Ongoing longer term series
- Other
Proposed Length of program *
- 90 min
- 2 hours
- 4 hours
- Over a span of a couple/few days
- Other
Please select the audiences you're hoping to target with these topics: *
- Children (under the age of 13)
- Youth (13 - 18)
- Young Adults (18 - 25)
- Adults 25+
- Parents/Caregivers
- Seniors 65+
- Imams and/or Religious Teachers
- Sunday School Teachers
- Youth Group Staff or Volunteers
- Social Services Staff (i.e. counselors, social workers, etc)
- Board/Executive Directors
- Other
Actual costs will be discussed during a follow-up call after this needs assessment form is submitted. Consider the cost of travel and lodging for HEART staff, especially if the program is outside of our current locations of Chicago, LA, DC, ATL, Houston and NYC.
Where programming will take place? *
- Virtual
- In-Person
If you have a proposal, please attach here:
Attach file
Drop files here
Please book a call with me here: https://calendly.com/navilafromheart/schedule
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