SDIP - Registration form

Are you interested in taking part in the Immersive Summer Sustainable Diversity & Inclusion Practitioner Certification program that will take place from August 26th to August 30th, 2024 in the Siena (Italy) countryside?

Let us know who you are and for what reasons you want to participate. Take a few minutes to fill in the following form. It is possible to register till Sunday 14th of May 2024.

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PERSONAL INFORMATION
Your first name: *
Your surname: *
Country of Residence *
Country of Birth *
Date of Birth *
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Gender *
Preferred Pronouns
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CONTACT INFORMATION
Contact Email *
Contact phone number *
PROFESSIONAL INFORMATION
Your highest level of education *
Specify your educational background *
Job title *
Organization / Company's name *
Type of Organization (HEI, Private Business, Non-Profit...etc.) *
How many years of experience, if any, do you have in the Sustainable or Diversity & Inclusion field?
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How did you learn about this training program?
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PROGRAM DETAILS
What are your specific goals and expectations for attending this training program?
 *
Are you currently working on any project related to Sustainability and/or Diversity & Inclusion?
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In case you are currently working on any project related to Sustainability and/or Diversity & Inclusion, or you have an idea you would like to develop, can tell us a bit more about it? What's the context? Who is your project's target? What's the project's goal?...
 *
Have you previously attended any training program on Sustainability and/or Diversity & Inclusion? 
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In case you have you previously attended any training program on Sustainability and/or Diversity & Inclusion, please specify the title of the program and the main contents you have covered:
What specific topics within Sustainability, Diversity & Inclusion are you most interested in learning about?
You can either send us your short video presentation via email at sustainabledip@gmail.com  or provide a link here to a max. 3-minutes video outlining why you are motivated to join this training program. *
CONSENT & ADDITIONAL INFORMATION
Do you give consent to be contacted by us for further event details and post-event follow-up?
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Do you have any additional questions or require further assistance regarding the training program?
Is there any additional information you would like us to know?
SUBMISSION & VERIFICATION
I certify that the information provided is accurate and complete to the best of my knowledge.
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