Institute of Impacted Leaders Interest Form
Please fill out this form to join our cohorts in Sacramento OR the Inland Empire, from March - June 2020. Sessions will be once a week, and begin Tuesday, March 3 for Sacramento and Thursday, March 5 for Corona from 6:30-9:00pm.
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Email *
First & Last Name *
Phone Number *
City *
Are you interested in the Sacramento or Corona Cohort? *
How are you impacted by mass incarceration? (Check all that apply) *
Required
Tell us more about yourself and how mass incarceration has impacted your life (3-5 sentences). *
Why do you want to join the Institute of Impacted Leaders? *
What is your vision for ending mass incarceration? (3-5 sentences). *
The Institute trainings will be held on Tuesday evenings (in Sacramento) and Thursday evenings (in Corona) from 6:30-9:00pm from March - June 2020. Does this date / time work for you? *
Can you attend the Institute Info Session on Tuesday, March 3 (Sacramento) or Thursday, March 5 (Corona)? *
In order to graduate from the program, you will be required to miss no more than 2 sessions AND attend an advocacy day in Sacramento on May 4, 2020 (or do an in-district lobby visit). Can you commit to these requirements? *
What support might you need to make it easier for you to participate in the trainings, such as transportation support, childcare, etc.?
Do you have any other questions?
A copy of your responses will be emailed to the address you provided.
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