Intro Social Justice Leadership Institute: Fall 2022 School Registration Form
Thanks for your interest in attending the Social Justice Leadership Institute! This retreat takes place Saturday and Sunday October 29th - 30th, 2022 at Phillips Academy Andover. SJLI focuses on racial, gender, economic and queer justice, racial and social identity development, expanded political analysis, personal leadership skills and community transformation tools. This interactive two-day overnight retreat brings together ~50 Independent high school student leaders from across New England. Our experienced staff team of organizers and facilitators supports this group to connect, challenge themselves and each other, build stronger relationships and take action together.

Please complete this form by October 17th to reserve your school's registration. By completing this form, your school commits to participating in SJLI. We offer discounted Early Bird registration ($450.00/student) until September 30th, 2022. Final registration ($500.00/student) closes October 17th, 2022. Your school's payment is due by October 28th, 2022.

After receiving this form, we will send you our student registration form to confirm the final names of your attending students. Your student registration forms are due back to us by October 19th, 2022. 
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Your School's Name *
Your Name  *
Your Role/Title on Campus *
Your Pronouns
Your Email Address *
Your Phone Number *
Do you commit to meeting the following criteria in your recruitment of student participants? *
Due to our popular education approach to racial justice learning, including being rooted in the experiences of those most impacted, we strongly recommend that your school's cohort is majority (preferably above 75%) students of color. Further, we encourage a diversity of socioeconomic background, gender, sexual orientation and class year to be considered when arranging your school's cohort. The specific application process your school uses to nominate individual attending students is up to you.
How many students from your school will participate? *
An invoice will be sent to you following your completion of this form. Your school's fee is based on the numbers you provide here. Student registration to confirm participating students is due by October 19th, 2022. Please let Mariko know as soon as possible if your attendance numbers change after completing this form. Schools are invited to send a minimum of 3 students and a maximum of 10 students in your cohort. 
Do you plan for participants to stay overnight? *
Students must provide their own sleeping materials (pillow, sleeping bag, sleeping mat) while Phillips Academy Andover will provide on-site sleeping space with breakout areas separated by self-identified gender. Meals will be provided on-site starting with Saturday breakfast snacks, lunch and dinner, followed by Sunday breakfast and lunch. Schools electing to skip the overnight are expected to stay at Phillips Academy Andover through 9PM Saturday evening and return to campus by 9AM Sunday morning.
Do you agree to the following chaperone policy? *
Chaperones are required for  Saturday morning drop-off, Sunday afternoon pick-up, and to be on call for emergencies. Chaperones who wish to stay on campus during the program will be provided with a designated space to hang out, read, work, nap, etc. After you complete this form, we will ask you to provide emergency contact information (full name and cell phone number) for your school's chaperone. Chaperones are welcome to leave campus during the program, should they wish to do so, but will be asked to stay in the local area in case of emergency. Chaperones are responsible for arranging their own Saturday night accommodations. (Remember, students spend Saturday night in sleeping bags on the auditorium floor!) 
Do you agree to the following cancellation policy? *
Should your school cohort no longer be able to attend SJLI, the following cancellation policy applies. Cancellation notice given before October 7th, 2022 incurs no fee. Cancellation notice given before October 21st incurs 50% of the invoiced fee. After October 21st, 100% of the invoiced fee is due. In the event of a cancellation, you may be able to transfer your school's reservation to a future SJLI.
What would you like us to know about racial and social justice at your school? Please feel free to share recent any context that might be helpful for our planning team.
What's Next?
Please expect to receive an invoice by email over the next few weeks based on the numbers you indicated in this form. Your school's payment is due by October 28th, 2022. You will also soon receive our student registration form (due by October 19th, 2022) to confirm individual student registration.

Please reach out to Mariko Dodson with any additional questions at

We look forward to working with you and your students!
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