Copper to Gold Opt-In Form # 2
Please fill out this form to sign up for a C2G Spring 2023 group. Once filled out. You will receive notice from us on the group time/date you have been assigned to. 
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First Name *
Last Name *
Email Address *
Phone Number *
City *
State ( Two Letter only, please) Eg: VA *
If you are not in the U.S please spell out your county name here. Thank you. Ex: Canada
Gender *
Which best describes how you experience the world?   *
Age Range: We ask this question to provide some diversity in age across groups when possible. Just check one box *
All faiths and no faith are welcome here. Please tell us, are you a Baha'i? *
Please identify any of the capacities you may be serving in the Bahai community during this course. This is entirely confidential like the rest of this information. Check all those that apply. *
Required
Have you participated in a CTG cohort previously? Check the most recent that applies. *
Required
 How did you hear about the CTG program? Check all that apply. *
Required
Have you participated in other anti-racism courses or programs? *
Required
Here is the calendar and times for available groups. On the next screen you will be asked to make your top three choices in Central Time. Use this chart to help you convert your time zone to central time. 
Select your top 3 meeting times. Please select "N/A" if any 2nd or 3rd choice times listed are not feasible for your schedule. ALL TIMES SHOWN ARE CENTRAL TIME. Groups begin the week of Sunday, March 19th.  *
Sun 12pm
Sun 4pm
Sun 6pm
Mon 1pm
Mon 7pm
Tue 7pm
Wed 4pm
Wed 7pm
Thur 4pm
Thur 7pm
Fri 11am
Fri 7pm
Sat 12pm
N/A
1st
2nd
3rd
FOR FAMILY MEMBERS/FRIENDS/GROUPS:  If you are opting-in with a family member, friend, OR group check only one of the three boxes below and provide the group or other individual's name in the next section.
Name of Individual(s) or Group Name
Are there any special needs you have in order to participate in the program?
Thank you!  We will contact you before your first meeting with your group assignment. In the meantime, please feel free to use this space if there is anything else you'd like us to know.  We can also be reached at copper2gold1@gmail.com if you have questions.  
Please identify any of these skills sets that you may have. These are not a requirement for participation.
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