Creative Reaction Lab Learning and Education Client Form

Creative Reaction Lab L&E Client Form

Welcome to the Learning and Education Services by Creative Reaction Lab. In pursuit of our mission, we consider our models to be part of our depth of our work. Our Learning and Education team equips people working in/intersecting with health & healthcare, schools and education, media, technology, nonprofits, government and Fortune 500 corporations with the concepts and mindset of Equity-Centered Community Design to provoke more intention and action toward equitable practices and organizational culture. For more information, please contact us at learning@crxlab.org.

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* 1. Contact or Representative Name

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* 2. Organization Name

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* 3. Contact Email

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* 4. Contact Phone Number

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* 5. Organization Address

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* 6. Preferred Mode of Engagement

In-person

Hybrid

Online

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* 7. Number of Attendees

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* 8. Type of Engagement (Select all that apply)

Workshop

Talk

Custom Designed Experience

Creative Reaction Lab Learning and Education Client Form

Creative Reaction Lab L&E Client Form

Question Title

* 1. Contact or Representative Name

Question Title

* 2. Organization Name

Question Title

* 3. Contact Email

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* 4. Contact Phone Number

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* 5. Organization Address

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* 6. Preferred Mode of Engagement

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* 7. Number of Attendees

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* 8. Type of Engagement (Select all that apply)

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* 9. Duration of Engagement(s) (In Hours)

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* 10. Possible Dates for Engagement(s)

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* 11. Time Zone of Engagement