Presenter Interest Form

Name*

First Last

Legal Name (if different than above)

First Middle Last

Pronoun(s)*

She/her/hers
They/them/theirs
He/him/his
Other

Address*

City State / Province / Region ZIP / Postal Code Country

Email*

Phone*

What topic most interests you? Please check all that apply:*

Other topics of interest (not listed above):*

Who do you envision in your audience?*

AdoptEd: Educational Workshops for Adoptive, Foster, & Kinship Families and Professionals
FosterEd: County and Tribal-based Workshop focused for Foster and Kinship Families
Professional Workshops: Educational Workshops for Professionals who work with adoptive and foster families.

What style of workshops are you interested in exploring? Please check all that apply:*

In person workshop
Webinar
Half-day workshop
Full- day workshop
Workshop series

Are you a therapist connected to Foster Adopt Minnesota's HELP Program?*

Yes
No

If no, would you like to learn the benefits of being a HELP-vetted therapist?*

Yes
No

Where in Minnesota would you be interested in presenting?*

Please share any experience you have working with adoptive, kinship, and foster families, and/or interactions you have had working with professionals who serve these families: (Add text box for them to write)*

What trainings have you provided in the past? Please provide specific information and make note if you have power points and curriculum you could share with us, if requested.*

How did you hear about this speaking opportunity?*

Your Presenter Bio*

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Foster Adopt Minnesota Education Program

Presenter Interest Form

Presenter Interest Form