Community Outreach Request

If you are interested in having someone from Safe Harbor come and speak to your group or staff a table at your community event, please complete the following request form. Someone will be back in touch with you as soon as possible.   Please submit this form at least 30 days before your event to allow us to find a staff member or volunteer to represent Safe Harbor at your event. We look forward to working with you!

Name of Group:*
Contact Name:*
First Last
Contact Phone Number:*
Contact Email:*
Type of Event:*
Will this event be in-person, virtual, or other?*
Location of Event*
Street Address City State / Province / Region ZIP / Postal Code Country
Date of Event*
MM slash DD slash YYYY
Start Time of Event*

: Hours

Minutes

AM/PM
End Time of Event*

: Hours

Minutes

AM/PM
Please provide a description of your event:*
Estimated number of participants:*
Who is the audience? (youth, college, adult, professionals, faith-based, community, etc.)*
Topics you are looking to have covered:*
- Domestic Violence
- Sexual Violence
- Human Trafficking
- Healthy Relationships
- How To Help A Friend Or Coworker
- Safe Harbor Services
- Other
*you may select more than one
How does Safe Harbor fit into the goals of your event?*
Will in-kind goods be donated?
Will a financial gift be donated?
Any other information that you think we may need to know:

If you have questions, please call 804-249-9470.

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Testimonials

Great experience and gained great amount of knowledge. Since this is so prevalent in today's society it is best to have the most information possible.

“I learned that I am as strong as I think I am, and that I am definitely a survivor.”
- T, domestic violence survivor

“Both my child and I have received counseling that has added to the quality of our life. I know that I am not alone, and that has made me a better parent.”
- I, domestic violence survivor

“I feel so fortunate to have found a program like Safe Harbor. I was greeted with smiles, a calming presence, and a place to heal and rebuild my life.Thank you!”
-M., domestic violence survivor

“Safe Harbor helped me to get a preliminary protective order against my abuser. Their services and support helped me to navigate the court system and feel more confident. I am very grateful for these resources and to know that I was not alone during this process.”
- M, domestic violence survivor

“It was very nice to have someone there to give me support while I was going through the process. She was very helpful and kind. I did not know that people like that existed anymore.”
- Survivor quote