This Application is for our RALEIGH, NC November 2021 Program

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Our Stories - Brave Conversations on Race

电子邮件地址 *

Name *

Cell phone *

Street Address *

City, State, Zip Code *

Age *

18-35

36-49

50+

Gender *

Female

Male

Non-Binary

Race *

Black or African American

White

Hispanic or Latino

Asian

American Indian

Multi-racial

We will be hosting several Conversation Groups this November 2021. Each group will meet online using Zoom six times over six consecutive weeks beginning the week of November 1st. 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? *

Yes

Are you available to meet WEDNESDAY nights from 7:30-9:15pm? *

Yes

Are you available to meet THURSDAY nights from 7:30-9:15pm? *

Yes

Are you available to meet SATURDAY mornings from 8:00-9:45am? *

Yes

What is your profession? If retired, list former profession. *