RCC Collaborator™ Interest Form
By Racially Conscious Collaboration™
Sign in to Google to save your progress. Learn more
Email *
Please note: The FOUNDATIONS OF RACIALLY CONSCIOUS COLLABORATION™ SEMINAR is a pre-requisite to start Collaborator™. Please list the date you completed Foundations below. *
Name *
My race and gender are... *
Cell phone number (Please enter in the following format +1 555-123-4567) *
I accept text messages *
Required
City, State *
Sector *
Required
Title/Role and Organization/workplace I would like to collaborate in... *
List your supervisor or organizational contact name and email where we may follow up for certification fee and contractual commitment. If self list "SELF". *
Cohort I'd like to participate in
Visit https://rcc-online.teachable.com. Scroll to the bottom of the page for Cohort dates. Check the box below if you agree to attend the required dates listed under the cohort you are interested in.
I learned about Tony Hudson and Racially Conscious Collaboration™ by....
I am interested in certifying as a Collaborator™ because...
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy