Flourish Agenda Learning – | Together we Flourish

Organization Information

"*" Indicates fields required for completion and form submission.

Name*

First Last

Title/Position

Phone

Email*

Enter Email Confirm Email

Organization Name*

Enter "Individual" if request is not affiliated with an organization.

Organization Main Phone Number

Organization Website

Address*

Street Address Address Line 2 City State ZIP Code

I am interested in booking Flourish Agenda for:*

Keynote Presentation
Healing Center Engagement Online Certification*
Training or Workshop
Healing Retreat
Camp Akili Youth Camp
Organizational Coaching or Consulting

HCE Course Options

*Healing Centered Engagement (HCE) is a non-clinical, strengths-based approach that advances a holistic view of healing and re-centers culture and identity as a central feature in personal well-being. This course will help youth development professionals explore ways they can enhance their practices and policies to more effectively reach and impact youth of color.

INDIVIDUAL USER MODEL

• May complete the certification and have access to the Learning Management System with all resources, documents and recordings for six months.

• Completed online and self-paced.

• Takes approximately 20 hours to complete.

COHORT MODEL

• The certification is completed in a cohort based model where participants progress through the course on a definitive timeline with their peers.

• The course takes approximately 20 to 25 hours to complete and will be scheduled over an 8 week period.

• The certification will be accompanied by two 90-minute live virtual sessions by a Flourish Agenda Trainer.

• Learners will have access to the Learning Management System with all resources, documents and recordings for one year.

Which model are you interested in?*

Individual with no Continuing Education Units
Individual with 3 Continuing Education Units
Cohort (15 to 40 people) with 2 coaching sessions no Continuing Education Units
Cohort with 2 90-minute coaching sessions and 3 Continuing Education Units

*Please note: Continuing Education Units are assigned by San Francisco State University and have an additional cost.

In which month(s) would you ideally like to begin the course?*

Do you already have a Cohort that will take the course?*

Yes
No

Will you be part fo the Cohort taking the course?*

Yes
No
I do not know yet.

How many people do you estimate will be in the Cohort?*

Event Information

Please provide a detailed description or scope for your project (include demographics of recipients of participants, number of stakeholders/providers, etc.)

Is this request for a scheduled event?*

Yes
No

Event Name

Event Date*

Event Location*

Same as Organization?

Yes
No
Virtual

Address

Street Address City State ZIP Code

What is the time frame or when would you prefer this to occur?*

How flexible is this time frame?*

Budget Range for Request*

Enter the budget range available for the type of support or programming being requested from Flourish Agenda.

Please share any additional details you think would be helpful to review your request including the name and contact email for the contract signatory.

What is the goal, or what problem are you trying to address?*

What are the outcomes that you want to see? What does success look like?*

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Phone

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