2024 Fall Online Living the Richmond Pledge to End Racism Workshop

Please complete this registration form for the Living the Pledge to End Racism Workshop to be held online via Zoom on Tuesdays, September 24 - November 12, 2024, from 6:30pm - 8:30pm ET. (No session Oct 15 or Nov 5)

Contact Information

Name *

First Name

Last Name

Email *

Verify Email *

Address *

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Phone

Greater Richmond *

Do you live or work in the Greater Richmond, VA, Region?

Yes

Special Message to people from outside of the Greater Richmond Region

We appreciate your interest in the Pledge to End Racism. In order to develop the Richmond Pledge to End Racism network, we give priority to people who live or work in the Greater Richmond Region. If the workshop fills up (which we do not anticipate at this time), we might have to cancel your registration to make room for Richmond-area folks.

If you are from a city outside of the Greater Richmond Region, please contact Annette Marquis and Anita Lee at info@pledgetoendracism.org about how to bring the Pledge to End Racism Initiative to your community.

Thank you for understanding.

Demographic Data

We use demographic data to aid us in creating diverse small groups. Please answer as you feel comfortable.

Congregation/faith community/organization

If you are affiliated with a faith community, congregation, organization, school, college, or university, please list it here.

Race/Ethnicty

Select the race/ethnicity you primary identify with or select other and enter your own

African American/Black/African Descent

Asian/Pacific Islander

Hispanic/Latino

Multiracial

Native American/Alaska Native

White

Another option

Race/ethnicity option

Generation *

What is your generation?

WWII Generation (b. 1901-1928)

Lucky Few/Silent Generation (b. 1928-1945)

Baby Boomer Generation (b. 1946-1964)

Generation X (b. 1965-1980)

Millennial Generation (b. 1981-1996)

Generation Z (b. 1997-2012)

Alpha Generation (b. 2013-)

I prefer not to answer this question

Gender

To which gender do you most identify?

Female

Male

Other (please specify)

Other Gender

Referral

Select all the ways you heard about this workshop

Through church

From a Richmond Pledge postcard/flyer

From a friend/family member

Through Facebook

Through an online search

Other

Please tell us other ways you heard about this workshop

Payment

While our workshop leaders and small group facilitators all donate their time to make these workshops happen, there are still costs associated with developing and promoting the Pledge and workshop. Please offer what you can to help us spread the Pledge to others, knowing that no one will be turned away based on ability to pay.

Amount *

$60 - Suggested donation

$75 - Pay it forward donation

$30 - Reduced registration