Juneteenth Freedom Academy for Facilitators Registration
The Juneteenth Freedom Academy for Educators is a weekend intensive for transformative facilitators designed by Alexis Pauline Gumbs, founder of the Eternal Summer of the Black Feminist Mind. The weekend intensive will take place in Durham, NC on Nov 1st and 2nd, 2014.
Name and Contact Information
Please include email and phone number and indicate which is the best way to reach you.
Your answer
Why are you interested in attending the Juneteenth Freedom Academy for Educators? *
What do you hope to get out of the training? How did you find out about it?
Your answer
Where does most of your facilitation happen? What communities are you directly accountable to with this work? *
Feel free to share your facilitation background and the spaces where you INTEND to facilitate.
Your answer
What teachers, facilitators and ancestors are you accountable to with your facilitation approach? *
Another way to think of this is who do you want to make proud with your present and future practices as a facilitator?
Your answer
What are your favorite ways to engage collaboration and new information? *
(choose as many as you want!)
Housing Needs *
Transportation Needs *
(During the Training)
Travel to the Training *
Geographical location *
What city and state do you live in?
Your answer
Food Preferences *
(What are your food preferences, dietary restrictions and allergies?)
Your answer
What are your accessibility needs?
Your answer
Funding Strategies *
The cost of the Juneteenth Freedom Academy for Educators is $475. Please indicate the strategies you will use to fund your participation.
Scholarship needs (only for scholarship applicants)
Please indicate the amount you are able to pay for the training (in addition to the $75 deposit). Note that Eternal Summer of the Black Feminist mind only fundraises for participants who have paid their initial $75 deposit.
Your answer
Any other information?
Is there anything else we should know?
Your answer
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service