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Virtual 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 Wednesdays August 12, 19, 26 & September 9, 16, 23 from 6:30pm - 8:30pm.

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

Demographic Data

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


If you are affiliated with a faith community, congregation, organization, school, college, or university, please list it here.
Select the race/ethnicity you primary identify with or select other and enter your own

What is your generation?
To which gender do you most identify?

Select all the ways you heard about this workshop

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.
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