Community Education Request

 

Please complete this request form if you are interested in having Alexandra House host an informational table at your event, conduct an educational presentation, or do professional training. We will follow up with you via email once you have submitted your request.

 

Due to the amount of requests we receive, we may decline your request. However, if a decline is necessary, we will contact you with other resources and/or contact information for your request. Thank you!

Company/Organization
Country
State / Province*
Address
City
Email*
Confirm Email*
Phone
Secondary Contact Person
Contact Information for Secondary Contact (please include: name, phone number and email)
Date of Event*
Location (Address) of Event*
Topic of Presentation*
  • Community/Resource/Health Fair
  • Responding to Domestic or Sexual Violence
  • Abuse in Later Life (Elder Abuse)
  • Sexual Violence 101
  • Domestic Violence 101
  • Alexandra House Services
  • Healthy Relationships (Youth)
  • Signs of Abuse in Young Children
  • Effects of Abuse on Children
  • Victim Rights
  • Civil and/or Criminal Process in Anoka County
  • Silent Witnesses (Silhouette Display)
  • Other
Number of People Expected
Length of Event
If informational materials requested: Date of Pickup/Return
Special Topics/ Instructions/Notes