#WeAreWeingart
Success Stories Spotlight

STEP ONE

Thank you for your interest in joining the #WeAreWeingart Movement. In order to participate in this experience, we first need to get some information from you.

To begin, simply complete the short questionnaire below, which is designed to verify your active or inactive client status at Weingart Center, and gather some preliminary information relating to your Weingart Center experience.

Once you have completed this questionnaire, we can began working together to craft quality content for your unique #WeAreWeingart Success Story.

Rest assured, Weingart Center will never sell your information to an outside organization or business, and we will never use your information for reasons other than what is intended here—and only with your express approval. If at any time, or for any reason, you feel uncomfortable answering any of the questions below, you are not obligated to proceed.

Ready to begin? Let’s do this.

Name

First Name

Last Name

Email

Most of our story collaboration will be conducted through emails. This form of communication offers documentation for both you and the Weingart employee who is working to help craft your unique Weingart Success Story. Please provide a good email address in the space below.

Phone

While most of our work together will be done via email, there might be moments when speaking over the phone will work to our benefit. Please provide a good contact phone number, including area code, where we can reach you if the need arises.

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When did you become a Weingart Client?

If you do not know the exact date that you became a Weingart client, that's okay. Just do your best. We can look it up.

MM

DD

YYYY

What is your client status?

I am an active Weingart client, and I am currently receiving services from Weingart Center.

I am an inactive Weingart client, and I no longer receive services from Weingart Center.

How was your Weingart Center experience overall?

My overall Weingart Center experience was/is:

Why do you want to participate in the #WeAreWeingart Movement?

In 1-3 short sentences, let us know why you want to be part of the #WeAreWeingart Movement. Do not use this space to tell your unique story. We will tackle those details in later correspondences.

Disclaimer

I understand that my participation in the #WeAreWeingart Movement is strictly voluntary and I am completing this form of my own volition. I feel comfortable providing the information requested, and I am voluntarily applying to see if my story will be included in future #WeAreWeingart materials and publications.

I understand, acknowledge, and agree .

#WeAreWeingartSuccess Stories Spotlight

STEP ONE

Ready to begin? Let’s do this.

© 2024 Weingart center; All rights reserved

#WeAreWeingart
Success Stories Spotlight