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Fall 2017 Living the Richmond Pledge to End Racism

Please complete this registration form for the Living the Richmond Pledge to End Racism Workshop on Saturday October 28 and November 11, 2017. 

Contact Information
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First Name
Last Name
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Address Line 1
Address Line 2
City
State/Province
ZIP/Postal Code
Country


What church, congregation, meeting, mosque, synagogue, or other faith community, if any, are you a member of/affiliated with? Please use as few acronyms as possible (UU is OK).
Select all the ways you heard about this workshop

Please tell us other ways you heard about this workshop
Select the race/ethnicity you primary identify with or select other and enter your own

What is your generation?
Payment
The suggested donation includes the workshop, workshop materials, lunch on Saturday, Feb 4, and coffee, drinks, and other snacks for both workshop days. If you're able to offer more, it will help spread the Pledge to others. If you're able to offer less, that's fine, too. No one will be turned away based on ability to pay.
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