{"id":1262,"date":"2022-06-21T11:27:46","date_gmt":"2022-06-21T11:27:46","guid":{"rendered":"http:\/\/breakthecycle.org\/i_3aii_requestformny\/"},"modified":"2023-12-13T15:25:22","modified_gmt":"2023-12-13T15:25:22","slug":"i_3aii_requestformny","status":"publish","type":"page","link":"https:\/\/www.breakthecycle.org\/i_3aii_requestformny\/","title":{"rendered":"Request a presentation in New York"},"content":{"rendered":"

Home<\/a> > Program information > Education & Outreach Program > Request a presentation > Presentation request form<\/p>\n

To request a presentation in New York, fill out the form below, print
\nit and then fax or mail it to:<\/p>\n

\nBreak the Cycle

\nP.O. Box 6270, F.D.R. Station
\n

\nNew York, New York 10150<\/p>\n

\u00a0\u00a0\u00a0\u00a0\u00a0Fax: 212.848.4678<\/p>\n

\n\n\n\n
\n

Requester’s Name:<\/p>\n<\/td>\n

<\/td>\nSchool or Organization:<\/td>\n<\/td>\nAddress:<\/td>\n<\/td>\nCity and State:<\/td>\n<\/td>\nZip Code:<\/td>\n<\/td>\n\n

Phone:<\/p>\n<\/td>\n

<\/td>\nFax:<\/td>\n<\/td>\nEmail:<\/td>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n



<\/p>\n\n\n\n
\n

Date(s) of requested presentation:<\/p>\n<\/td>\n

<\/td>\nTime\/period(s) for requested presentation:<\/td>\n<\/td>\nLength of presentation requested:<\/td>\n<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n




\nI would like the presentation to (check all that apply):
\n

<\/p>\n\n\n\n\n
\u00a0\u00a0\u00a0<\/td>\naddress the dynamics of dating and domestic violence.

<\/td>\n<\/tr>\n
\u00a0\u00a0\u00a0<\/td>\ndiscuss the civil and the criminal law related to domestic violence and the legal options available to young victims of dating and domestic violence.<\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Participants are:<\/p>\n\n\n\n\n\n\n\n\n\n\n\n\n\n
\n

Youth:<\/p>\n<\/th>\n<\/tr>\n

<\/td>\nMiddle school students<\/td>\n<\/td>\n9th<\/sup> graders<\/td>\n<\/tr>\n
<\/td>\n10th<\/sup>, 11th<\/sup> or 12th<\/sup> graders<\/td>\n<\/td>\nCollege students<\/td>\n<\/tr>\n
<\/td>\nOther:
\n<\/td>\n<\/tr>\n
\n

Adults:<\/p>\n<\/th>\n<\/tr>\n

<\/td>\nLaw students<\/td>\n<\/td>\nOther graduate students<\/td>\n<\/tr>\n
<\/td>\nTeachers<\/td>\n<\/td>\nSchool counselors<\/td>\n<\/tr>\n
<\/td>\nSchool administrators<\/td>\n<\/td>\nParents<\/td>\n<\/tr>\n
<\/td>\nSocial service providers<\/td>\n<\/td>\nHealth care professionals<\/td>\n<\/tr>\n
<\/td>\nAttorneys<\/td>\n<\/td>\nLaw enforcement<\/td>\n<\/tr>\n
<\/td>\nMental health professionals<\/td>\n<\/td>\nOther: <\/td>\n<\/tr>\n<\/tbody>\n<\/table>\n

Is this presentation part of a larger event? Yes\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 No

\nIf so, please describe:<\/p>\n

\n

Although all Break the Cycle’s programs are offered free of charge, we depend on the community for support. To cover our time, travel and materials costs, we ask for-profit organizations (including private schools), if they are able, to reimburse Break the Cycle with a minimum donation of $100 per presentation.<\/p>\n

Will you be able to reimburse Break the Cycle for these costs?

\n Yes\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 No<\/p>\n

Parking information or directions:<\/p>\n<\/form>\n

\u00a91998-2003 Break the Cycle. All Rights Reserved.<\/p>\n","protected":false},"excerpt":{"rendered":"

Home > Program information > Education & Outreach Program > Request a presentation > Presentation … Read more<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"_links":{"self":[{"href":"https:\/\/www.breakthecycle.org\/wp-json\/wp\/v2\/pages\/1262"}],"collection":[{"href":"https:\/\/www.breakthecycle.org\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.breakthecycle.org\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.breakthecycle.org\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.breakthecycle.org\/wp-json\/wp\/v2\/comments?post=1262"}],"version-history":[{"count":1,"href":"https:\/\/www.breakthecycle.org\/wp-json\/wp\/v2\/pages\/1262\/revisions"}],"predecessor-version":[{"id":3835,"href":"https:\/\/www.breakthecycle.org\/wp-json\/wp\/v2\/pages\/1262\/revisions\/3835"}],"wp:attachment":[{"href":"https:\/\/www.breakthecycle.org\/wp-json\/wp\/v2\/media?parent=1262"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}