2019 CBE'S Regional Leadership Academy Application
Communities for a Better Environment in Northern CA wants to work with you in becoming a stronger leader for Environmental Justice. #EJ4ALL!

We will be having regional training monthly on Saturdays (Dates and times are provided below). Every training will include free child care, transportation, interpretation, and food.

Goals: Advance Environmental Justice leadership and skills of our core and new leaders.

Highlights: CBE will engage leaders around grassroots feminism and what a feminist economy looks like!

Each training offers a stipend.

Join us for our 3rd CBE Regional Leadership Academy!

PLEASE FILL THE APPLATION COMPLETELY OUT AND GIVE FULL DETAILS. Contact us for any question or help. If you have any question, please contact your nearest CBE organizer. (Si tiene preguntas contacte un/a organizador@ de CBE) 510.302.0430 Esther@ x24 & Angela@ x21 & Zolboo@ X14 & Andrés@ x15
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Las oficinas de Comunidades para un Mejor Medioambiente en Richmond y East Oakland quiere trabajar con usted para convertirse en un líder más fuerte para la Justicia Ambiental.

Vamos a tener entrenamientos semanales, el sábado (fechas y horarios se proporcionan a continuación). Cada entrenamiento incluirá cuidado de niños, transporte, interpretación y comida gratis.

Metas: Fortalecer liderazgo y habilidades de la justicia ambiental en nuestros miembros.

CBE involucrará lideres alrededor del femenismo y lo que seria una economia feminista!

Los asistentes reciben un estipendio por cada sesión a la que asistan.

¡Únete a nosotros para nuestra 3ra Academia Regional de Liderazgo CBE!

Email address *
(Full Name) Nombre *
Your answer
(Gender Pronoun: She/Her, They/Them, He, Him, etc.) Pronombre de genero
Your answer
(Full Street Address, City, Zip) Direccion *
Your answer
(Phone) (xxx)xxx-xxxx Teléfono *
Your answer
(Email Address) Correo electrónico *
Your answer
(Any Organization invovlement ) Organizacion *
(Person to Notify in Case of Emergency) Contacto de emergencia
Please give CBE's information to your emergency contact
(Full Name) Nombre de contacto de emergencia *
Your answer
(Phone) (xxx) xxx-xxxx Telefono *
Your answer
(Emergency Contact Email Address) correo electrónico *
Your answer
(Food Allergies, Dietary Restrictions, and Needs) restricciones dietéticas *
(Shirt Size) Talla de Camisa *
(Regional Leadership Academy Dates, Locations to be Determined, If you need transportation please let us know, in the NOTE box below.) Dias del liderazgo, Lugar a determinar. Si necesita transportacion, avisenos abajo.
(June 22nd) 22 Junio 10 am - 3 pm (Saturday) Sabado &
(July 27th) 27 Julio - 10 am - 3 pm (Saturday) Sabado &
(August 10th) 10 Agosto - 10 am -3pm (Saturday) Sabado
(Interests) Intereses
*
Required
(We Want To Know) Queremos saber
(WHAT does Environmental Justice mean to you? Please give details) ¿Qué significa la justicia del ambiente a usted? *
Your answer
(WHY do you want to join the Regional Leadership Academy (RLA)? Please give details) ¿Porque quiere participar en la Academia de liderazgo regional? *
Your answer
(Previous Academy Experience, Please give details) Experiencia previa de la academia
Summarize your previous Leadership Academy experience or Community Training.
*
Your answer
NOTES, ADDITIONS, OR NEEDS WE NEED TO KNOW. PLEASE ADD HERE / Cualquier otra información que quisiera compartir, agrege aqui
Your answer
(Agreement / Signature) Acuerda y firma
(Signature) Firma *
Your answer
(Date) Fecha *
Your answer
If you have any question, please contact your nearest CBE organizer. (Si tiene preguntas contacte un/a organizador@ de CBE) 510.302.0430 Esther@ x24 & Angela@ x21 & Zolboo@ X14 & Andrés@ x15
A copy of your responses will be emailed to the address you provided.
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