L&E Client Intake Form

Thank you so much for your interest in Creative Reaction Lab! In order to customize your engagement, please fill out the form below. Upon completing this form, please allow for at least 3-5 business days for our team to review the details before reaching out to you with regards to next steps.

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* 1. Name of Contact/Representative

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* 2. Email and/or Phone Number ( Contact Information)

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* 3. Name of Company

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* 4. Date(s) of Engagement

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* 5. In-Person or Online
Note: If requesting an in-person event, the client is responsible for all costs related to travel.

In Person

Online

Other (please specify)

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* 6. If In-person, where is the event located? ( i.e., address)

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* 7. Type of Organization

Non-profit

Student Organization

Grassroots Organization

Municipal Government Agency

Early Childhood Learning Center

Elementary/Middle/High School

College/University/Higher Education Institution

Hospital/Clinician Based Agency

Social Service Agency

Foundation

Corporation

Other (please specify)

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* 8. Size of Organization

5-10

10-25

25-50

50-100

100+

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* 9. Estimated Number of Attendees

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* 10. Organizational Budget (Yearly)

Welcome to the Learning and Education Services by Creative Reaction Lab. In pursuit of our mission, we consider our models to be part of our depth of our work. Our Learning and Education team equips people working in/intersecting with health & healthcare, schools and education, media, technology, nonprofits, government and Fortune 500 corporations with the concepts and mindset of Equity-Centered Community Design to provoke more intention and action toward equitable practices and organizational culture.

Learning Opportunities

Equity Design Lecture Series / Keynote Talk
Equity by Design Immersives / ECCD Immersive
Institute for Equitable Design and Justice / Membership

Equity Design Lecture Series | Keynote/Talk
Specialized packaged content in a Keynote style talk from 30 to 90 minutes. Depending on speaker selection, the talk can be led by either our Founder, President and CEO, or one of our Lead Facilitators. The keynote will feature select interactive prompts, followed by up to 15 minutes of fireside chat engagement and/or a question and answer session. Requests for any talk to be moderately tailored to your organization's needs/requests will need to be requested and approved a minimum of 30 days before the engagement.

Equity by Design Immersives | ECCD Immersive
In the Equity by Design Immersives, Creative Reaction Lab leads organizations through the Equity-Centered Community Design (ECCD) framework, addressing an organization’s internal problem and/or challenge. From this foundation, participants examine the ways in which they can design more inclusive and equitable policies, programs, interventions, etc., ultimately integrating this approach in their institutional practices and mindset.

Institute for Equitable Design and Justice| Membership
Launching for private organizational clients in 2023, the Institute for Equitable Design and Justice is an equity design educational community of practice whereas, our online learning institute is specifically designed for your organization. This model features a course around Equity-Center Community Design (ECCD) as well as mini courses that would be released throughout the year. CRXLAB will host private live sessions where your team/organization could bring tangible questions that participants have around equity. Organizations would receive early access to a variety of tangible and interactive activities and materials that could be easily applied in your communities or space. Your organization would also have access to a private coach and account manager.

A customized online learning experience designed specifically for you and your team to holistically and systematically address your real world , everyday challenges. The CRXLAB team will help your organization work through these issues as you all are each building your acumen and knowledge around equities and the community design and how to apply ECCD.

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* 11. Select a Learning Opportunity ( Type of Engagement)

Equity Design Lecture Series

Equity by Design Immersives

Institute for Equitable Design and Justice

L&E Client Intake Form

Question Title

* 1. Name of Contact/Representative

Question Title

* 2. Email and/or Phone Number ( Contact Information)

Question Title

* 3. Name of Company

Question Title

* 4. Date(s) of Engagement

Question Title

* 5. In-Person or Online
Note: If requesting an in-person event, the client is responsible for all costs related to travel.

Question Title

* 6. If In-person, where is the event located? ( i.e., address)

Question Title

* 7. Type of Organization

Question Title

* 8. Size of Organization

Question Title

* 9. Estimated Number of Attendees

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* 10. Organizational Budget (Yearly)

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* 11. Select a Learning Opportunity ( Type of Engagement)

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* 12. Budget for Engagement (please note, our starting rate for our engagements is $3,995)

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* 13. Who is your audience?

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* 14. What do you hope for your attendees to take away from this engagement?

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* 15. Comments ( Please provide us with any additional information you feel we should know in preparation for this engagement).

L&E Client Intake Form

Question Title

* 1. Name of Contact/Representative

Question Title

* 2. Email and/or Phone Number ( Contact Information)

Question Title

* 3. Name of Company

Question Title

* 4. Date(s) of Engagement

Question Title

* 5. In-Person or OnlineNote: If requesting an in-person event, the client is responsible for all costs related to travel.

Question Title

* 6. If In-person, where is the event located? ( i.e., address)

Question Title

* 7. Type of Organization

Question Title

* 8. Size of Organization

Question Title

* 9. Estimated Number of Attendees

Question Title

* 10. Organizational Budget (Yearly)

Question Title

* 11. Select a Learning Opportunity ( Type of Engagement)

Question Title

* 12. Budget for Engagement (please note, our starting rate for our engagements is $3,995)

Question Title

* 13. Who is your audience?

Question Title

* 14. What do you hope for your attendees to take away from this engagement?

Question Title

* 15. Comments ( Please provide us with any additional information you feel we should know in preparation for this engagement).

* 5. In-Person or Online
Note: If requesting an in-person event, the client is responsible for all costs related to travel.