Equity or Else Campaign: 2024 Racial Equity Summit
Date: August 18, 2024 
Time: 4:00pm - 6:00pm CST
Location: Insight Hospital ( formerly Mercy Hospital) , Chicago, IL

Upon completion of this form, you will receive a call/email from your J4J Regional Organizer to confirm your registration with 2-3 days. YOUR REGISTRATION IS NOT COMPLETED UNTIL YOUR REGIONAL ORGANIZER HAS CONFIRMED.
Sign in to Google to save your progress. Learn more
Region *
Organization *
Contact Name *
Phone Number
Email *
Organization Address *
What is Your Organizations Area of Focus around the Quality of Life Agenda? (Select all That Apply)
HOW MANY PEOPLE WILL BE ATTENDING FROM YOUR ORGANIZATION?  ( Please note a list of attendees will be required for the day of event. All requests to add on must be requested and approved by Regional Organizer ) *
 ADDITIONAL NOTES
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Kenwood Oakland Community Organization. Report Abuse
Google Forms