2019 SF-CESS Equity-Based I-Group Facilitator Training Application*
*Acceptance is based on space, payment, completion of this application and the readiness as indicated in some of the answers.
Email address *
Participant Last Name *
Participant First Name *
Title *
Phone *
(to use if we need to contact participant about any major changes)
Organization
Street Address *
City *
State *
Zip *
Q1: Please explain in about a paragraph why you want to attend SF-CESS' Equity-Based iGroup Facilitator Training? *
Q2: Please explain, in about a paragraph, what work you have done personally and professionally that prepares you to facilitate equity centered, transformational collaboration with others? *
Demographic Information (for planning purposes)
Gender *
How do you identify?
Race *
How do you identify?
Role *
(select the role/capacity/lens you are bringing most in participating in this training)
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) 483-0933 or email us at thecenter@sfcess.org. Full payment is due prior to the first day of the seminar.
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 invoice date, standard late fees may apply.
Payment *
How will you pay? Full payment is due prior to the first day of the seminar.
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
Email
Phone
Street Address
City
State
Zip
A copy of your responses will be emailed to the address you provided.
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