This Application is for our WILMINGTON, NC October 2021 Program
Our Stories - Brave Conversations on Race
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Email *
Name *
Cell phone *
Street Address *
City, State, Zip Code *
Age *
Gender *
Race *
We will be hosting several Conversation Groups this October 2021. Each group will meet online using Zoom six times over six consecutive weeks beginning the week of October 4th. Each group will meet for 1 hour 45 minutes. Let us know your availability.
Are you available to meet TUESDAY nights from 7:30-9:15pm? *
Are you available to meet WEDNESDAY nights from 7:30-9:15pm? *
Are you available to meet THURSDAY nights from 7:30-9:15pm? *
Are you available to meet SATURDAY mornings from 8:00-9:45am? *
What is your profession? If retired, list former profession. *
How did you hear about Our Stories-Brave Conversations on Race? *
Please tell us why you want to participate in this program. *
A copy of your responses will be emailed to the address you provided.
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