Professional Wellness Workshops for Organizations Registration Form

These highly interactive workshops bring mindfulness expertise and experiential learning to your organization. Participants will learn tools, techniques, and tips to increase their effectiveness and engagement at work and other areas of their life.

Please Contact Natanya Mandel for more information: nataya.mandel@mindfulnesseveryday.org.

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Name of Organization

Tell us about your organization…motto / vision - mission statement / focus / population

Organization Full Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Theme/Title of Event/Workshop/Presentation

What are you hoping to get out of the presentation? Can you provide two learning outcomes?

Contact Person Name & Position/Title

Contact Person Email

Cell Phone - Contact Person

Business Phone with Extention

Workshops Details

Number of Participants attending (Our Preferred Size is maximum of 30 per session)

Description of Venue (Preferred chairs in a circle, possibly the Library, or Meeting room with enough space for some movement activities). We also require a PowerPoint projector with sound capability. Our facilitator will supplly a laptop with HDMI connector. If this is not available, please let us know.

Preferred Date / Start Time

Date

Time

Length of Session

Please complete the following so that we can best plan your presentation. The workshop facilitator will contact you to finalize details.

Some
None
Experienced
Mixed

Any questions/ special requests?

Invoicing Details

Please complete the following so that we can send the invoice to the correct person/department.

Invoicing Contact Person Name & Title

Invoicing Contact Person Email

Invoicing Details to be included:

Agreed Fee:

Minimum Price: $850.00

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