GWI Intake Form

First Name*
Last Name*
Email*
example@example.com
Phone Number
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Title
Organization/Group Name*
State your organization is based in*
Website
How did you hear about our services? Who referred you to us? (select all that apply)*

Your newsletterThe Good Work HourHeard good things from a colleague or partnerAttended the workshop Democratizing WorkAttended the workshop Navigating ConflictAttended the workshop Navigating FeedbackAttended a GWI event at the GreenhouseMet with a member of the GWI teamFiscally sponsored project of GWIOther
Type of organization (select all that apply)*

Arts and CultureCommunity InitiativeEducationEnvironmental JusticeNon Profit OrgLocal, State or Regional Government EntityBusinessPhilanthropyCommunity OrganizingOther
Type of request (Please select all that apply)*

Speaking Engagement (e.g. Keynote)Trainings / WorkshopsCoaching / ConsultingFacilitationOther
Do you want to be added to our mailing list?*

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Please tell us a little bit about your project and request.*
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