Professional Development & Training Client Intake Form
Thank you for your interest in partnering with Restorative Response Baltimore. This form helps us understand your organization’s goals, needs, and logistics so we can design a training experience that is aligned, impactful, and restorative.
Organization Information
Organization Name
*
Primary Contact Name
*
First Name
Last Name
Title / Role
*
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Organization Website
Type of Organization
*
Nonprofit
School / Educational Institution
Government Agency
Faith-Based Organization
Corporate / Private Sector
Community Group
Other
If Other, please specify
Organization Mission and Population Served
*
Training Overview
Type of support sought
*
One-time training (1–3 hours)
Half-day training (3–4 hours)
Full-day training (6–8 hours)
Multi-session series
Ongoing partnership / consulting
Conflict resolution support
Community conferencing services
Strategic planning / facilitation
Other
If Other, please specify
Preferred Training Date(s)
Is the date flexible?
*
Yes
No
Estimated number of attendees
*
Please Select
10–20
21–40
41–75
75+
Participant roles
*
Executive Leadership
Mid-Level Managers
Frontline Staff
Board Members
Volunteers
Mixed Group
Youth
Other
If Youth, please specify ages
If Other, please specify role
Goals & Outcomes
Top 3 goals for this training
*
Current challenges or tensions
*
What will be different if this training is successful?
*
How does this training align with organizational values or strategic priorities?
Program Options
RRB program interests
*
Introduction to Restorative Practices
Affective Communication Skills
Building a Restorative Workplace Culture
Accountability & Repair Frameworks
Safety vs. Comfort in Organizational Culture
Dismantling Harmful Power Dynamics
Leadership & Restorative Decision-Making
Community Conferencing Overview
Circle Keeper Training
Customized Program
If customized, what specific focus areas are important?
Logistics & Planning
Training format preference
*
In-Person
Virtual (Zoom)
Hybrid
Location (if in-person)
Address
City / State
Who will secure the location?
*
Client secures venue
RRB secures venue (additional cost may apply)
Room setup preference
Circle seating
Tables (round)
Classroom style
Auditorium
Not sure / Need guidance
Will food or refreshments be provided?
Yes – Client will provide
Yes – RRB should coordinate (additional cost)
No
AV / Technology available on site
Projector & screen
Sound system
Wi-Fi
Flip charts
Not sure
Investment & Budget
Is there a budget range allocated for this training?
*
Under $1,000
$1,000–$3,000
$3,000–$7,500
$7,500+
Not yet determined
Is this training funded by a grant?
*
Yes
No
Funding source
Decision-making process / who needs to approve this engagement
*
Readiness & Alignment
Has your organization previously engaged in restorative practices or similar training?
*
Yes
No
If yes, please describe the previous experience
Are there any sensitive topics we should be aware of in advance?
SECTION 8: Follow-Up
Preferred next step
30-minute discovery call
Proposal with pricing
In-person planning meeting
Virtual planning meeting
Anything else you’d like us to know?
Cost & Scholarship Information
Professional development and training opportunities may have an associated cost. Final pricing will depend on the scope, format, number of participants, and specific training needs.
Would you need scholarship or financial assistance in order to participate?
*
No
Yes
Maybe / I would like more information
Please briefly describe your scholarship or financial assistance needs.
Scholarship or financial assistance is not guaranteed and may depend on available funding. RRB will follow up with additional information regarding pricing, availability, and any applicable assistance options.
Internal checklist
Alignment with RRB mission
Capacity available
Pricing tier
Custom proposal required
Potential long-term partner
Submit
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