Service Contact Form
First Name
Last Name
Street Address
Address Line 2
City
State/Province/Region
Zip/Postal Code
Phone Number
Country
Email Address
Type of service requested:
Workshop/In-service/Facilitation/Training
Public Spaeking/Lecture
Consultation
Other
Topic:
Effective Interactions with African-American Males
African-American Student Academic (Dis)Engagement
African-Centered Rites of Passage
African-Centered Education
Valuing Diversity from the Inside Out
Taking Ownership of Education/Parental Engagement
Protecting Our Children From The Racism Plaguing American Schools
Other
Please provide as much detail as possible such as: 1. Possible dates? 2. Who is the audience (students, professionals, parents, etc...)? 3. Time frame (45 mins., 3 hrs, 1 day, 3 days, etc..) 4. What is it that you want to accomplish?
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