Rebuilding Self Esteem During White Supremacist Times Online Course
Welcome to Rebuilding Self Esteem During White Supremacist Times! This is your first step. Congratulations! You've made it this far. <3

- All of this information is helpful to me. It helps me know where you're at and what goals you have for taking this course.

-Whatever you write is confidential and will not be shared with anyone.  

-Once you have filled out this google form and venmoed me, I will send you the link to the course!

I'm so looking forward to working together!

xoxo
Noa

IG@noacoffeycoaching
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Name/s *
Pronouns *
Phone Number *
Email *
Instagram Handle (optional; if you would like to follow one another)
What are your Identities? (race, class, etc) *
Where are you finding the most white supremacy in your day? Work? School? News? *
What are some of your goals in taking this course? *
When I say words like social justice and racial equity, what comes to mind?* *
How did you find out about this course?
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The cost for this course is $250-500. I have limited $100 spots available. Which price do you choose? *
If you chose a $100 spot, please share briefly about your identities and your financial situation
I understand I will venmo @Noa-Coffey before the course link is sent to me.
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