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Your data is kept confidential. None of it is available to the public.
Only your Name, City, Telephone and Email address are provided to facilitators listed in this search. Welcome!

POTENTIAL WORKSHOP PARTICIPANTS: Thank you for entering your information in order for us to notify you of upcoming workshops.

FACILITATORS: Thank you for entering your workshop participants' data. Just in case you are concerned about any errors or uncertainities, be assured that all new individuals entered are reviewed by Pat Hardy, so that we have consistency in the data entry and can use your information effectively.

If you have questions, the following people have volunteered to offer phone support to answer your questions. Ann Boone 707/326-2907 (cell); Pat Hardy 805/886-9773 (cell) or 800/905-6765 (answering service).

CONTACT INFO
First name
Nickname
Middle name
Last name
Login name
Password
Gender
Affirmation/Adjective name
Previous Affirmation names
Date of birth (month, day, year)
Address
City
State
Zip
Home phone
Work phone
Cell phone
Fax
Email
Website
Regional AVP Council
Your Local Friends Meeting (Optional)
Other
AVP INFO
Basic Taken (year)
Basic Lead Facilitator
Basic location
Advanced/2nd Level Taken (year)
Advanced/2nd Level Lead
Advanced/2nd Level Location
T4T AVP Taken (year)
T4T AVP Lead
T4T AVP Location
T4T HIPP Taken (year)
T4T HIPP Lead
T4T HIPP Location
Most recent Prison Orientation date
(month, day, year)
I am certified as facilitator in:
(select all that apply)



I am certified as Lead in:
(select all that apply)



My availability to train:
(select all that apply)







Availability other
Languages in which you can facilitate
Presently facilitating regularly at:
As a facilitator, I need financial or in-kind help with:
(select all that apply)



AVP Kit/Box:
(select all that apply)


I can provide overnight lodging to other AVPers:  
Area of particular strength in AVP:
Workshops facilitated this year:
AVP conferences attended:
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