Let’s work together.

Name *

First Name

Last Name

What kind of organization are you? *

NGO/Non-profit

Corporate/Private Sector

Government/Public Sector

Other (please describe)

What services are you interested in? *

Mental Health Workshop

LGBTQ+ Inclusion Program/Consult

LGBTQ+ Education/Workshop

Speaking Engagement

Other (please specify below)

When would you like these services to occur?

MM

DD

YYYY

Do you want an in-person or virtual engagement? *

In-person

Virtual

Both

Unknown