event set-up form
About You
Your Name:
*
First Name
Last Name
Email:
*
Which of the following best describes you?
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I am a Facilitator-in-Training (currently in Level 2)
I am a Certified Facilitator (graduated from Level 2)
I am a Practitioner-in-Training (currently in Level 3)
I am a Certified Practitioner (graduated from Level 3)
Are you leading this event with a co-facilitator?
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Yes
No
Who will you be co-facilitating your event with?
*
Please note your co-facilitator must be in active training or certified with Eat Breathe Thrive
Your Website:
Your Social Media Handles:
e.g, Linkedin, Instagram, Facebook, TikTok
Please provide a short professional biography for use in promotional materials. Your bio should briefly describe your role and background, highlight your experience and how long you have been working in this field, and share your motivation or interest in this work.
*
Maximum 150 words
0/200
Please upload a professional headshot of yourself
*
Upload
Minimum specs: 1,000pix wide, 300 dpi resolution, and 1MB size
Cancel
of
Please upload any action photos you would like to be included in promotional materials about your courses. For example, photos of you practicing yoga or leading groups in action.
*
Upload
Please ensure you have consent from anyone depicted in the photos before uploading and sharing.
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of
About Your Event
Will your event or course be held online or in person?
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Online
In-Person
Name of Venue:
Street Address:
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City
*
State / Province
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Country
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Zip / Postal Code
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Website of Venue Location, if applicable:
In what language will your event(s) be offered?
*
What event or course will you be leading?
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Seven-Week Series
Yoga for Eating Disorder Recovery
Campfire Social Event
Other
On what day will your sessions take place?
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Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays
At what time will your sessions take place?
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Minutes
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until
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What time zone will your course or event take place in?
*
Start date:
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Month
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Day
Year
Date
End date:
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Month
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Day
Year
Date
Do you need to add any by-weeks?
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No
Yes
On what date will you be having a by-week?
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-
Month
-
Day
Year
Date
Will you be charging a fee for your course?
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Yes
No
Full Fee:
*
Early-Bird Fee:
*
expires two weeks before start date
Will you be offering scholarships for this course?
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Yes
No
What scholarship model will you use (select all that apply)?
*
I will offer full scholarships
I will offer partial scholarships
What fee will scholarship recipients pay for the course?
*
Date & Time (Eastern Standard Time)
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Month
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Day
Year
Date
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What is the theme of the Campfire Event?
*
The Mind
How We Eat
Intimacy
The Body
Identity
Growing Older
Grief & Loss
Hope & Cynicism
Confessions
Failure
Addiction
Creativity
Promoting Your Event
Would you like our support in promoting your course or event?
*
Yes
No
What do you hope people will get from this experience?
What inspired you to lead this course or event?
What do you want people to know about this course or event?
Is there anything else you would like us to know?
Submit
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