TEAM Individual Intake

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Email *

First Name *

Last Name *

Name of Organization *

Your Role/Title *

Preferred Racial Narrative/Ethnicity (in other words, how do you like to define your racial background)?

Age. You can put your actual age or your age range (e.g. 20-30, 50-60) *

Gender identity and/or pronouns?

In general, how versed is your TEAM in talking about issues of race? *

1- I/We have never or avoid it

2- We are aware of racism and other forms of oppression

3- We are more than aware, we know racial justice is important but we don’t know how or what to do about it

4- We have taken some collective action, done some learning together

5- We could/do lead conversations about race, regularly engage in learning and collective action, our staff of color feel included and heard

Please explain your answer to the previous question *

In general, how versed are YOU in talking about issues of race? *

1- I have never or avoid it

2- I am are aware of racism and other forms of oppression

3- I am/We are more than aware, we know racial justice is important but we don’t know how or what to do about it

4- I have taken some collective action, done some learning

5- I could lead conversations about race, regularly engage in learning and collective action, our staff of color feel included and heard

Please explain your answer to the previous question *

What is/are the primary outcomes you are hoping for your TEAM? *

Have foundational terminology

Know your why, why you are in the fight for racial justice

Want resources and tools for deepening learning

Want to be able to take more racially just, antiracist, informed, and ongoing action

Other:

What is/are the primary outcomes you are hoping for YOU? *

Have foundational terminology

Know your why, why you are in the fight for racial justice

Want resources and tools for deepening learning

Want to be able to take more racially just, antiracist, informed, and ongoing action

Other:

Has your team participated in racial affinity groups or caucusing? If so, how has that experience been for you?

Which 2-3 areas of The Wheel do you think your team should prioritize? Are there other areas of development for your team you think should be considered? Wheel: https://840e3de2-3c45-4ee2-ba07-5ac71fb0552b.filesusr.com/ugd/671e09_6215f4a3ef56417da62b932dbba73040.pdf *

Is there anything else you would like me to know or consider about YOU or your TEAM?

Submit

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