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RCC Collaborator™ Interest Form
By Racially Conscious Collaboration™
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Email
*
Your 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.
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Your answer
Name
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Your answer
My race and gender are...
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Your answer
Cell phone number (Please enter in the following format +1 555-123-4567)
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Your answer
I accept text messages
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Yes
No
Required
City, State
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Your answer
Sector
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Business/Corporate
Education
Entreprenure
Finance
Government
Health & Wellness
Law Enforcement/Safety
Non-Profit
Philanthropy
Other
Required
Title/Role and Organization/workplace I would like to collaborate in...
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Your answer
List your supervisor or organizational contact name and email where we may follow up for certification fee and contractual commitment. If self list "SELF".
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Your answer
Cohort I'd like to participate in
October 6 - December 2, 2022 [Orientation: 10/6, 5-6pm CST]
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 will attend the required sessions listed for the cohort I select. I will sign a commitment at orientation.
I learned about Tony Hudson and Racially Conscious Collaboration™ by....
Your answer
I am interested in certifying as a Collaborator™ because...
Your answer
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