Registration Form

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Registration Form

Thank you for your interest in joining this workshop on nonviolence and movement building. Please take the time to fill out this registration form completely, the workshop facilitator will adjust the curriculum of the program in order to best meet everyone's needs and interests, as best they can. Also please stay tuned for a bit of pre-work before the workshop begins. Be sure to indicate in this registration form if there are any accommodations that you require in order for you to participate in this workshop in a meaningful way.

If you have any questions please call our Program Manager, Kyle Silliman-Smith, at 863-2345 x6 or e-mail her at kyle@pjcvt.org.

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Phone

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What is your experience with nonviolence?

What inspired you to sign up for this workshop?

Please include if you are currently working on a social justice campaign that you would like to be explored as an example in this workshop. If so, please include details and know that the facilitator may follow-up before the first session begins.

What aspect of this workshop most interests you?

How do you think you can use the skills of this training in your life?

Have you participated in activism utilizing the principles and strategy of nonviolence?

If so, please explain your experience.

How much can you contribute financially? We ask for $20 for the general public and $15 for current PJC members and volunteers. People under 25 are not expected to contribute financially. No one will be turned away for lack of funds.

Please let us know if you have questions

Is there anything else you would like the facilitator to know?

Examples: font size needs, language interpretation, connections to other participants, request to invoice employer for a finacial contribution amount, etc.

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