THE CONDUIT COLLECTIVE
A Trauma-Informed Training & Directory Collective — Partner Intake Form
Full name
*
First Name
Last Name
Email address
*
example@example.com
Phone number
Please enter a valid phone number.
Format: (000) 000-0000.
Business/practice name
Your profession/modality
*
Please Select
Doula/Birth Worker
Advocate/Mackenzie Friend
Lactation Consultant
Solicitor/Paralegal
Therapist/Counsellor/Psychologist
Somatic Practitioner
Dietitian/Nutritionist
Other (please describe)
Tell us about your practice and your approach
*
Where are you based, and do you work online, in person, or both?
*
How many pro bono slots would you like to offer?
*
Are you interested in discounted enrolment on The Conduit, our 12-week advanced professional training launching September 2026?
*
Yes please — send me details
Maybe later
No thank you
A short bio for social media
A photo you're happy for us to use on social media
Upload a File
Drag and drop files here
Choose a file
Cancel
of
Your social media handles
Pricing
Tell us a little about how you price your services.
What do you typically charge for your services?
*
Please share your usual starting rate or pricing range.
Any notes on your pricing structure?
Share anything helpful about how your fees are structured.
Anything else you'd like us to know?
Submit
Should be Empty: