ARTF Champion Team Interest Form
Please complete this Anti-Racism Task Force Champion Team Interest Form if interested in training and engagement with this task force. Thank you.
Email *
Please provide your first and last name. *
Are you?
Clear selection
Please provide your home address. *
Please provide your church's name and what town/city it is in. *
What district is your church in?
Clear selection
Please provide your cell phone number. *
Please list any dietary or mobility restrictions.
When planned events occur requiring travel, would you like to participate in a carpool? If so, please provide a statement below which best represents your interest. If you ride with someone, we ask that you offer a small monetary amount to assist with commute expenses. Check all that apply in order of preference.
Will drive if needed
Prefer riding with someone
Open to driving or riding
Not interested in a carpool
1st choice
2nd choice
3rd choice
4th choice
Please let us know how you found out about the Champion Team. For example, give the name of the person who referred you, was it through your District's Shepherding Team, or was it through the weekly eNews or the monthly Reporter.
Acknowledgment of Understanding
By completing this form, you understand that Anti-Racism Champion Team Members are:

• Passionate about dismantling systemic racism within our church and society
• Willing to engage through prayer, training and dialogue, and outreach over the next 18 – 36 months
• Willing to participate in bi-monthly (every other month) or quarterly Zoom meetings to stay informed
• Prayerful and discerning about God’s desire in doing this work

Members should take the Chicago Regional Organizing for AntiRacism Introduction to Systemic Racism course. Rev. Matthew Krings is the Lead Contact for scheduling and recruiting for this course. If you have not participated in this training, he will be in touch with you with additional details.

Thank you for your support and interest.

Rev. Jerrod Severing & Nadia Kanhai
NIC Anti-Racism Task Force Co-Chairs
AntiracismTF@umcnic.org
By completing this form, you acknowledge your understanding of and agreement with the above Acknowledgment of Understanding. *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy