Full Name
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Organization/School/Church Name
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Email
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Phone Number
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Preferred Date(s) or Timeframe
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What type of event are you interested in?
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Workshop
Speaking Engagement
Panel Discussion
Other
Is this event virtual, in-person, or hybrid?
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Virtual
In-Person
Hybrid
Who is your primary audience? (Check all that apply)
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Male Youth (Grades 9–12)
College-Age Men (18–25)
Adult Men
Fathers / Mentors
Staff / Educators / Leaders
Other
Estimated number of participants
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1-25
26-50
51-100
100+
Which emotional intelligence topics are most important for your group?
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Self-Awareness
Communication
Emotional Regulation
Fatherhood & Leadership
Vulnerability & Identity
Conflict Resolution
Other
Are you interested in learning about available session packages?
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Yes
No
Not Sure Yet
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