Work With Alexis – Organization Interest Form
For organizational representatives interested in bringing Alexis in for workshops or programming. Tell me a little about your organization and what you're navigating — I'll follow up personally to talk through what could work.
Organization Name
*
Your Name & Title
*
Email
*
example@example.com
Phone
Please enter a valid phone number.
Format: (000) 000-0000.
Organization Type
*
Please Select
Treatment Center
Juvenile Justice / Detention Facility
School or Co-op
Group Home
Behavioral Health Agency
Nonprofit / Youth Organization
Other
Who do you primarily serve?
*
Youth (12–15)
Youth (16–19)
Adults
Both youth and adults
Other
What are you hoping to bring me in for?
*
Please Select
One-time workshop or keynote
Ongoing / recurring programming
Not sure yet, want to talk
Other
What's the biggest challenge you're seeing right now with this population?
*
Timeline
*
Please Select
ASAP
Within 3 months
3–6 months
Just exploring
Best way to reach you
*
Email
Phone call
Text message
How did you hear about Alexis?
Submit
Should be Empty: