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Montana

General Information Form

Thank you for your interest in The Resilience Center programs and services. Please help us to respond personally by submitting the following information.

Name *

Company Name *

City *

State/Province *

Phone Number *

Email *

Your Position

Setting * Please Select your setting

Middle or Secondary Schools
College or University
Organizational Development and Change
Wellness Programs
Coaching Services
Clinical Services

Product(s) Please select the product(s) you are interested in offering

Resilience Scale II
Resilience Profile for Adults
Resilience Supports Scale
Resilience Supports Profile
Resilience Assessment for Youth
Resilience Profile for Youth
Resilience curriculum for Middle School and High School Students with Teacher Training
Resilience Scale for Children (RS-10)
Data analysis, scorecards, and summary reports

Briefly describe the work for which you plan to use the resilience programs or products

How many participants will be involved?

What is the approximate date that this work will begin?

Do you have other questions about our products and services that we can answer for you?

Would you like to set up a brief telephone meeting with us to further discuss your work?

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