Event Request FormCrisis Number. Free. Confidential. 24/7313-474-SAFECrisis Number. Free. Confidential. 24/7313-474-SAFEIf you would like Avalon Healing Center to provide training at your event, please fill out the event request form below. Requesting Party (Individual / Organization) * Your Email * Co-Sponsors (If Applicable) Event / Training Contact Person * Contact Phone Number * Event Date Event Time Allotted Topic(s) Requested *Bystander InterventionHandling Disclosures of Sexual AssaultHealthy Relationships/ConsentHuman TraffickingMedical Forensic Exams/History of Forensic NursingProviding Culturally Relevant SupportRape Culture/Gender NormsSexual Assault and the Criminal Justice SystemTeen Dating Violence/IPVWC SAFE Services/ProgramWorking with Trauma SurvivorsOther Purpose and Goals of Event / Training * Location of Event / Training * Parking / Security / Special Instructions A/V Setup Available? *YesNo Expected Number of Attendees *Less than 2021-5051-100100+ Participant Demographics Were there any incidents that occurred within your organization or with an individual that prompted this request? *yesno if Yes to Above, Please Explain