Name *

First Name

Last Name

Phone

(###)

###

####

What best describes your role?

Select all that apply.

Human Resources professional

Diversity, Equity and Inclusion specialist

Community Organizer

Nonprofit professional

K-12 educator or administrator

Higher Education faculty or administrator

Faith-based leader

None of the above

Do you have a set group who will participate or will students opt in?

We have a set group

We will let group members choose to participate

We are not sure yet

Are you interested in offering live coaching and/or a retreat for your group? *

If yes, we can send you pricing for these options.

Yes

No

Not Sure Yet

For organizations who need it, Freedom Lifted can accept payments for courses over two installments. Is your organization interested in this option?

Yes

No