Peer Learning For Professionals Registration

First Name*
Last Name*
Email Address*
Title
Organization
Phone
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Which Peer Learning Group are you interested in joining?*
To help us create productive cohorts of peers, please answer the following questions:
Describe your experience with 21/64?*
How does what your learned from 21/64 show up in your current practice and body of work?*
What are you hoping to learn from 21/64 through this experience?*
What are you hoping to learn from your peers through this experience?*
What skills or expertise will you bring to your peers in your group?*
What challenge are you facing that you would like help from the peer learning group through the structured peer consultation?*
Please contact Robyn at [email protected] with any questions.
Choose Your Training*
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$0.00
Agreement*
- Click here to accept 21/64’s intellectual property policy.
Credit Card*

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Card Number Expiration Date Security Code Cardholder Name
If you are experiencing financial hardship at this time please contact us for options.
Cancellation:
Payment is needed to confirm your seat and workshop fees are nonrefundable. We understand things happen and will try to take into account any extenuating circumstances that result in cancellation and apply payment to a future training within 12 months.

Peer Learning Topic	Launch Date	Schedule
Professionals Working With Families	Monday, June 29 at 12:00-1:30 ET	June 29 July 6 July 13 July 20
Engaging Wisely	Monday, July 27 at 12:00-1:30 ET	July 27 August 3 August 10 August 17
Practitioners of Color Working with Families	Tuesday, August 4 at 12:00-1:30 ET	August 4 August 11 August 18 August 25
Independent Consultants to Families	Wednesday, August 5 at 12:00-1:30 ET	August 5 August 12 August 19 August 26

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