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Kansas Reproductive Justice Leadership Institute Application 2018
The Reproductive Justice Leadership Institute (RJLI) offers a weekend-long overview of the reproductive justice movement and an introduction to URGE: Unite for Reproductive and Gender Equity and our campaigns. The Institute is open to young people (ages 18-25) who are new to activism and/or reproductive justice and located or living in Kansas.

This year the Kansas RJLI will be happening October 27-28 at Wichita State University! Participants are required to attend the full weekend. URGE will provide travel to and from the RJLI campus location, hotel and most meals for all participants.

Please fill out the application below if you'd like more information and/or to be considered for participation!

Deadline: October 10th, 2018
Questions? Contact Nigel Morton at (202) 337-2265 or nmorton@urge.org
Learn more about URGE here: http://urge.org/

Name (First & Last) *
Your answer
Legal Full Name *
Name on ID for hotel and travel purposes
Your answer
Email *
Your answer
Phone number *
Your answer
Emergency contact *
Your answer
If accepted, your number will be added to a group messaging system with the rest of your RJLI cohort for communication purposes. Do you wish to opt out of this? *
Are you attending the GSMC Pre-Conference? *
Street Address
Your answer
City *
Your answer
State *
Your answer
Birthdate *
MM
/
DD
/
YYYY
Race/Ethnicity
Sexual orientation
Gender identity
Gender pronouns *
However you want to be referred to as (example: she/her, him/his, they/their)
Your answer
Are you part of an URGE chapter? (Note: it is not necessary to be in an URGE Chapter to attend the RJLI) *
Are you currently in school? (Note: it is not necessary to be in school to attend the RJLI) *
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