Crossroads "Introduction to Systemic Racism" Training Application
Thank you for your interest in attending the Crossroads "Introduction to Systemic Racism" Training. We will likely be rescheduling the training due to CDC recommendations in response to COVID-19.

Registration will remain open and planning team members will be in touch once new details are in place.

Participation is limited to 75 individuals. Priority will be given to those who demonstrate a commitment to addressing racial inequity in our community.*

Participation is not confirmed by submission of this form.

*If written communication is not your strength, please contact BTCC at btccbloomington@gmail.com or call (812)335-7276.
Name *
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Email *
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Phone number (only used for last-minute communications if necessary) *
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Organization(s) you are involved with and your role, if applicable *
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What motivates you to commit to an all-day training on systemic racism? *If written communication is not your strength, please contact BTCC at btccbloomington@gmail.com or call (812)335-7276. *
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We are committed to this training being financially accessible, regardless of ability to pay. We ask each participant to pay a $25 registration fee, if possible. If you would like to contribute more, to sponsor another participant, please do. The fee, if any, will be due (via check made out to Youth Services Bureau of Monroe County) when you arrive at the training. Please indicate below how much you plan to pay. Thank you! *
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Please let us know if you require any additional accommodations. We will do our best to meet them within the limitations of our space and budget.
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Anything else we should know?
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