Institute of Impacted Leaders Summer '23 Interest Form - Contra Costa County and Surrounding Areas

The Institute of Impacted Leaders is a 12-week organizing training program designed for people directly impacted by incarceration. 

The goal of the Institute is to work toward ending incarceration by activating the power of those of us who are most harmed by it. Because the intent of the punitive justice system is to rob us of our power, it is critical to remind ourselves of the types of power we can never lose, and develop our skills to be as effective as possible in organizing and advocating for ourselves.

Participants learn the basics of community organizing, how to change statewide laws, and how to advocate for themselves and their loved ones both in and out of prison.

The only requirement to apply for an institute cohort is that you be directly impacted by incarceration - either formerly incarcerated or you've had a loved one who is or has been incarcerated, and you are interested in learning how to advocate for the freedom of all people. 

Please fill out this form if you are interested in joining our Summer '23 Contra Costa Institute of Impacted Leaders cohort from August - October 2023.
  • Training sessions will be once a week, on Thursdays from 6:30-9:00pm.
  • An Institute Information Session will be held on Thursday July 13th, from 6:30 PM - 9:00 PM. Attendance will be REQUIRED in order to be considered for the cohort.

Please complete this form by Friday, June 23rd to be considered for our Summer '23 cohort. 
Cohort participants will be notified within one week following the Info Session by email.

Sign in to Google to save your progress. Learn more
Email *
First & Last Name *
Preferred Pronouns
Phone Number *
What city do you live in? *
How are you impacted by mass incarceration? (Check all that apply) *
Required
Tell us more about yourself and how mass incarceration has impacted your life (3-5 sentences). *
Why do you want to join the Institute of Impacted Leaders? *
What is your vision for ending mass incarceration? (3-5 sentences). *
Can you attend the Institute Info Session via Zoom on Thursday, July 13th from 6:30 - 9:00 PM? *Please note the Info Session is MANDATORY in order to be consider for acceptance into the program.
*
Please RSVP NOW for the Mandatory Information Session scheduled for July 13th - 6:30 - 9:00 PM  REGISTRATION FORM

*PLEASE TYPE "REGISTERED" IN THE BOX BELOW ONCE YOU'VE COMPLETED THIS STEP
 *
Do you have any questions?
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This form was created inside of Initiate Justice. Report Abuse
Google Forms