Race Institute Intensive at Pingry - Registration for June 16-20, 2024

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for registering. We will send confirmation and other information to both your work and personal emails. Please check your spam or junk folders.

First Name *

Last Name *

Name of your school/organization *

Position title *

Work Email address *

Home Email address
*

The best number to reach you *

How do you identify racially? *

Are you a Race Institute alum? *

Yes

What other anti-racist workshops have you attended? *

Please tell us a bit about who you are. *

What do you hope to get out of the Race Institute Intensive workshop? *

Is there anything else that we should know about you?

The workshop begins on Sunday evening and runs through Thursday morning. Because of the experiential nature of the workshop, participants are expected and required to stay for the entire experience. Participants who need to miss a day at the last minute will be prohibited from participating in the rest of the workshop. Are you committed and available to participate for the entire experience? *

Yes

An invoice for the cost of the registration fees will be sent to you and your school upon receipt of your registration. To whom should the invoice be addressed? (Please include name and email address) *

Food allergies or eating restrictions, if any. *

Mobility Issues or Restrictions, if any. *

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms