Community Conversation Registration Form

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Community conversation “We Are Of: A Conversation on Race, Land and Culture”

The topic of land and the environment has become increasingly visible and contentious as climate change, urban development, and the growing needs of communities across the country create massive changes. In the face of these changes, feelings of belonging, connection, and responsibility are often evoked: this conversation hopes to reflect on these feelings. Beyond sharing perspectives and opinions, this conversation also hopes to have participants identify the ways their race and culture have shaped the way they view their environment and what similarities and differences they may have to other Alaskans. This conversation is an opportunity for all of us to critically engage with our views on a topic so deeply intertwined with the Alaskan experience.

12:00-1:30pm
Zoom Meeting
October 27, 2021

Email Address *

First Name *

Last Name *

Mailing Address

Age *

20-29

30-39

40-49

50-59

60-69

70-79

80-89

Other:

Gender *

Female

Male

Nonbinary

Other:

Required

Ethnicity (This information is collected for grant purposes) *

African American

Alaskan Native

Asian

Caucasian

Latinx / Hispanic

Native American

Pacific Islander

Other:

Required

Statement A: I understand that by registering for this workshop I am committing to:

1. Attending the online meeting (or emailing the hosts at alaskaywca@gmail.com if I need to cancel).

2. Not recording audio or video of the meeting.

3. Respecting confidentiality and not retelling stories told by others without their permission.

4. Listening respectfully to others but also listening to my own needs and opting out of any listening or speaking as needed.

5. Never selling or otherwise using this workshop format or related materials for profit.

Please note your response after reading statement A (above): *

I have read and I can agree to the statement above

I don't agree to the statements above

Statement B: I understand that sharing and listening to stories can sometimes trigger overwhelming feelings. While listening and sharing, I will try to pay attention to my own needs and step away or pass whenever needed. I also understand that all sharing is optional.

Please note your response after reading Statement B (above) *

I have read and can agree to the statement above

I don't agree to the statement above

Thank you for completing this form. Please click to submit, below. If you have any questions you can contact us at (907) 644-9600 or email

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