Application for Waitlist

Buy 1 Give 1 and Pay it Forward

It’s easy to apply to receive free Listening Game Cards products and services. Simply share a brief story that tells us a little about you and your interest in Listening Game Cards. For example,

How your financial situation prevents you from affording the products and services
How you plan to use Listening Game Cards

For Individuals

In the message box below, briefly describe in 300 words or less:

What you do for work or, if not employed, student or other status
How your financial situation prevents you from being able to access self-help tools such as Listening Game Cards

DO NOT include sensitive personally identifiable information such as social security number, driver’s license number, passport number, or other sensitive information.

By completing the form you acknowledge that your story may be used, anonymously, in Listening Game Cards materials and by us to report our results.

For Small to Mid-sized Non-profits and First Responder Agencies

Organizations can apply for up to 10 sets of free cards! In up to 300 words, Please tell us how you will use Listening Game Cards and what benefits you anticipate for your group. For logistical reasons, organzations are not eligible to apply for training and practice sessions.

Sliding scale group training and practice sessions are available. Please mention your interest here and use the Contact Us form to arrange a time to talk about the sliding-scale service model.

Form

What are you applying for?

Check up to 3 boxes for individuals. If you are applying for yourself and an organization, please submit two separate applications: one for you and another one for the organization.

Myself - Listening Game Cards

Myself - Level 1 Virtual Training

Myself - Virtual Practice Sessions (Coming in 2024!)

Non-Profit or 1st Responder Organization - Listening Game Cards (up to 10 sets)

My Situation - Why I'm applying and how I'll use the cards

For organizations, please indicate how you plan to use the card sets. Let us know if you want to schedule private training.

Name

First Name

Last Name

Organization Name and URL (if applicable)

Email

Phone

(###)

###

####

Shipping Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Anonymous Sharing Agreement

Please click on the check-box below before submitting your form – by doing so you are confirming that you understand that your story might be shared anonymously in future Listening Game Cards related materials or presentations.

Yes, I Agree

Copyright Agreement

Please click on the check box below before submitting your form – by doing so, you are agreeing that you shall not copy, reproduce, or redistribute, in any form, any or all ©Roundtable Group Consulting, LLC | Listening Game Cards hard-copy, PDFs, or digital feelings and needs cards or products including word lists, worksheets, instructions, or any materials in any form, for any purpose. All Roundtable Group Consulting, LLC | Listening Game Cards products and materials are copyrighted, proprietary materials owned by Roundtable Group Consulting, LLC ©2023 All Rights Reserved.

Yes, I Agree