Request Form - PEACEFUL FAMILIES PROJECT

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Training/Program/Consultation Request Form

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Type of Event *

Topic: Choose 1-2 *

Islamic Perspective of Domestic Violence Islamic Model of Healthy Families Islamic Perspective of Mental Health Sexual Violence Responding Effectively to Domestic Violence Healthy Teen Relationships Working Effectively with Muslim Families & Communities Professional Workshops for Religious Leaders Positive Communication Using Faith to Address Child Abuse, Sexual Assault & Domestic Violence Pre-marital & Marriage Addressing Divorce Other

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Social Media (Facebook, twitter, etc.) Programs Colleague, friend, family member Online research Other organizations Newsletter Other

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Location of Event (address, city, state, country) *

Length of Event *

Approximate Audience Size *

Organization *

Can put N/A if individual

Organization Website link *

Has PFP presented here before? If yes, what topic? *

Preferred Date of training *

Preferred Time of Day for Training *

Preferred Day of Training *

Sunday Monday Tuesday Wednesday Thursday Friday Saturday

Name for point of contact *

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Last

Who can we reach out to for questions?

Position Title *

Description of Audience *

Phone *

Comments *

Email *

Address (if different from above) *

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City

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Home
About PFP
About DV
Programs
Resources
Events
- Imam & Chaplain Training
Contact
Donate