SJTI Professional Institute Application - December 2022
December 5-9, 2022 - Long Beach, CA . Selection emails will go out the week of September 26, 2022.  Please make sure the email sjtiadmin@sjti.org is cleared for your email system and/or be prepared to check your junk email.  Do not make travel and accommodation plans until you have been notified of your acceptance.  
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First Name *
Last Name *
Pronouns *
Position/Title *
Describe your responsibilities *
Institution or place of work *
Work Address - Street *
Work Address - City *
Work Address - State *
Work Address - Zip Code *
Work Phone *
Phone number must follow the following format: xxx-xxx-xxxx.
Cell Phone *
Phone number must follow the following format: xxx-xxx-xxxx.
Email *
I understand that I must be up-to-date with all available COVID-19 vaccines and boosters by November 18, 2022 in order to participate and that I may be asked to present my vaccination card for verification during program registration on December 5. *
Required
Have you applied to SJTI before? *
If you've applied to SJTI before, were you accepted and had to decline? *
Is anyone else applying from your institution or organization? *
If you answered yes to the question above, please list names
Scholarships
SJTI offers a limited number of $100.00 scholarships that will be used to offset the cost of the institute. To learn more, go to: https://sjti.org/professional-sjti#5c89dad7-50bd-4f62-bf19-e53b3beeeb10 (link will open in a new window)
Would you like to be considered for a $100 need-based scholarship? *
If you answered yes to the question above, why?
Social Identities
Do you identify as multiracial or monoracial? *
Multiracial: I identify as someone with a heritage of two (biracial) or more races.     Monoracial: I identify as someone with a heritage of a single race
How do you identify Racially/Ethnically? *
If biracial/multiracial, please note that and then include all racial groups that comprise your heritage
Gender Identity? *
Age? *
Sexual Orientation? *
Religion/Spirituality? *
Socioeconomic Class of Origin? *
Nationality? *
Ability/Disability? *
List any other social identity group memberships that you feel are relevant to your work as a racial/social justice educator or practitioner on issues of race & racism *
Short Answer Questions
Describe your experience as a as a racial/social justice educator or practitioner exploring issues of race & racism (intended outcomes; how long; target populations; general formats for sessions; ways to engaged resistance; etc.): *
Describe your understanding of race dynamics and white supremacy in your organization and in society today: *
 Write about the developmental areas you need some work on as well as issues and dynamics you bump into, feel triggered around as an educator/practitioner on issues of race & racism. Also, comment on the skills and competencies you hope to deepen during the institute: *
How did you hear about SJTI? *
Please list specific names and institutions/organizations
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