Standing in Our Power (SiOP) 2016 New York City Empowerment Workshop Series Application Form
Thank you for your interest and taking the time to complete this application.

If you have not done so yet, please review the 2016 NYC Empowerment Workshop Series call for applications for details about this program, as well as frequently asked questions. If you have additional questions, please contact

Name *
Organization and Title/Role *
Number of years at current organization *
Address *
Website *
Email *
Phone Number (work) *
Phone Number (mobile) *
Please indicate the best time to reach you via phone. *
Background Information
Standing in Our Power (SiOP) recognizes that every individual is unique, that the aspects and combinations of diversity are infinite and that individuals are not reducible to demographics. We collect demographic data to ensure that we are achieving our goal of diversity and inclusivity. Please complete this section to the extent that you are comfortable. We truly appreciate all the information you are able to offer.
Race/Ethnicity - Please select all that apply
Country of Birth
Year of Birth
Sexual identity (ex: straight, lesbian, queer, etc.)
Gender identity (ex: female, transgender, etc.)
Class (ex: upper class, middle class, working class, raised poor but now XXX, etc.)
Issue areas you currently work on *
Narrative Questions
Please take some time to reflect on the questions and/or prompts below and answer in the first person. We value your openness and assure that what you share will remain confidential among SiOP facilitators. Your answers will help to shape our agenda and allow us to prepare to welcome and support you through this journey.
I am standing in my power when... *
What keeps me from standing in my power is ... *
Please share a bit about your experience as a woman of color social justice leader? *
Please tell us about any hopes you have for the Empowerment Workshop Series (retreat and half-day workshops). *
What conversations/questions are ripe for you at this time as it relates to your life and leadership? *
At the end of the workshop series, what would transformation look like for you? *
Please describe any previous leadership development training that you've participated in, or coaching that you've received.
Please share any concerns or questions that you have at this time. *
Logistical Information
Please confirm that you can make all of the dates outlined in the invitation. *
Dietary Restrictions *
Travel and Accommodations *
Thank you for your application. Please let us know if you have any questions at this time. Or, there is anything that we need to consider to prepare for you.
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