Student Application for Ending Racism Together: Liberation for All

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Please answer these questions in your application to attend Ending Racism: Liberation for All, and Justin and Shelly will get back to you as soon as they are able.

Email *

Phone Number (for the application process) *

Name *

Reason for wanting to join this workshop? *

Demographics

Cultivating a group of folk in this program who are representative of our entire society is incredibly important to this work. Please identify yourself to the best of your ability, and know that our goal is to include all who apply if at all possible. Your responses will be kept in the strictest of confidentiality.

How would you identify yourself or your lineage, ethnically? Please check all that apply. *

Of Indigenous African descent

Of Western European descent

Descendent of American Indigenous culture

Of Asian descent

Of Pacific Island descent

Descendent of Eastern Europe

Other:

Required

Age range *

18-24

25-32

33-39

40-50

51-60

61-70

71-84+

Option 8

Other:

What work have you done in the past to expand your understanding of social justice and equality? (if none, don’t worry… you can be honest.) *

What is your biggest struggle as it relates to the movement toward equality? *

The cost of the program, including room and board (and all meals) for the entire week starts at $896 for a sleeping bag space, and ranges between $1,312 - $2,625 for Standard Rooms depending on room type availability and/or whether or not you choose to share with a roommate. There are also premium rooms available at various price points. Please select one of the following: *

I am able to pay my way

I will not be able to attend without a partial scholarship

I need a full scholarship in order to attend

To bring greater equity to the program, this program aims to provide full scholarships to those in need thanks to the generosity of our donors. Are you able to help provide full or partial scholarships? All donations are fully 501(c)(3) tax deductible. *

Yes, contact me about helping to provide scholarships

No, I am unable to provide scholarships at this time.

Send me a copy of my responses.

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