Adult ANYTOWN® General Interest Form   
Community Tampa Bay has launched an adult version of its acclaimed ANYTOWN® program, with the mission of empowering participants to actively contribute to a more inclusive and equitable community. Through this 3-day, 2-night program, participants will gain skills to help decrease biases & prejudices, increase dialogue & cross-cultural interactions, and engage in genuine inquiry- all in pursuit of a community free from all forms of discrimination. 

In 2024, 91% of our ANYTOWN® graduates reported that their experience gave them a positive vision for change in their community, and it is our goal to continue this work by transitioning the success of our youth programming into adult spaces. 

This serves as a preliminary interest form as final participants of the 2025 Adult ANYTOWN® cohort will be selected and contacted at a further date. 
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Email *
Full Name  *
Preferred Name 
Pronouns *
Gender *
Race/Ethnicity *
Religious Affiliation *
Job Title/ Profession
Email Address *
Phone Number  *
Home Address  *
Have you participated in or attended any CTB programs before?  *
If you answered yes to the previous question, what CTB programs have you participated in and when?
Have you participated in anti-discrimination work before?  *
If yes, please provide more information below. 
What insights are you looking to gain from your experience at the Adult ANYTOWN® program? *
If you have any more to add to this section, please include it below. 
Are there any learning, physical, or mental accommodations that you would like to inform facilitators about that might help them better serve you during the Adult ANYTOWN® experience?  *
The program fee for the 2025 Adult ANYTOWN® program is $1,750. 

Community Tampa Bay is committed to providing an Adult ANYTOWN® program that is inclusive to all, which includes socio-economic diversity. We do not intend for the program fee to prevent anyone from participating. Below, please select the fee that best fits your income level and budget. 

Base Fee: The base program fee is $1,750. 

Pay- it- Forward Fee: Please consider paying 14% more to contribute toward the participation of more community members if you have the ability. 

Reduced Fee: You can select the reduced fee if you have difficulty covering basic expenses for you/your household, have medical expenses that are not covered by insurance, and/or have limited financial support or income. 
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