SF-CESS Equity-Based I-Group Facilitator Training Application
Participant Last Name
Your answer
Participant First Name
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Title
Email
(to send pre-training materials)
Your answer
Phone
(to use if we need to contact participant about any major changes)
Your answer
Organization
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Street Address
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City
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State
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Zip
Your answer
Why do you want to attend SF-CESS' Equity-Based iGroup Facilitator Training?
Your answer
What work have you done personally and professionally that prepares you to facilitate equity centered, transformational collaboration with others?
Your answer
Demographic Information (for planning purposes only)
Gender
How do you identify?
Your answer
Race
How do you identify?
Your answer
Role
Diet Restrictions
We will work with our caterers to maximize meeting reasonable dietary needs; we cannot accommodate individual orders. Depending on the specificity of your needs, you may want to bring foods you know you will be able to eat.
Logistics and Payment
To ensure a smooth application and registration process, please fill out each of the fields below with the most accurate information available to you. If you have questions or are unsure how to answer, call SF-CESS at 415.992.5007 or email us at thecenter@sfcess.org
For which week do you wish to register?
*If you are able to attend either week, please check both and we will place you in the week based on numbers and demographics
Required
Attendance Requirement Acknowledgement
Required
Registration Type
Please choose the registration type that fits your circumstance. PLEASE NOTE: If payment is not made by the due date, all discounts will be voided. Dependent on payment date, standard late fees may by applied
Payment
How will you pay?
Who is responsible for payment?
Check if address for billing is same as the address provided above
Payment Contact Information
If your organization is providing payment on your behalf, please provide the billing contact information below.
Billing Contact Name
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Email
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Phone
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Street Address
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City
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State
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Zip
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