Application Form
Please note that participation in the program requires that you register as an affinity group with at least four and no more than eight members. We strongly advise groups of nine or more to break into smaller cohorts and fill out a separate application. If you have questions prior to applying, contact support@ruthking.net.

Note: Participant emails listed below will be used for log-in purposes.

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Email *
Name of the Designated Coordinator *
First and last name
Email of Designated Coordinator *
First and last name
Name of your company or organization, if applicable
How many people are in your racial affinity group? *
What is the racial identity of your affinity group (Indigenous Nation, African, White Irish, Latin, White Jewish, Asian, Pacific Islander, African American, BiRacial, etc.)? *
What are the gender identities of your group members? *
Group Member #1 (Name) *
First and last name
Group Member #1 (Email address) *
Group Member #2 (Name) *
First and last name
Group Member #2 (Email address) *
Group Member #3 (Name) *
First and last name
Group Member #3 (Email address) *
Group Member #4 (Name) *
First and last name
Group Member #4 (Email address) *
Group Member #5 (Name)
First and last name
Group Member #5 (Email address)
Group Member #6 (Name)
First and last name
Group Member #6 (Email address)
Group Member #7 (Name)
First and last name
Group Member #7 (Email address)
Group Member #8 (Name)
First and last name
Group Member #8 (Email address)
How will your group meet each month? Note: It will be up to your group to arrange meeting logistics. *
What city, state, and/or country does your group members represent? *
Include all locations
Acknowledges *
Include all locations
Required
Share your group's motivation and intention for signing up! *
Include all locations
A copy of your responses will be emailed to the address you provided.
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