Train the Trainers Application

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This is the application for the Cultural Humility in Practice Train the Trainers program, led by Dr Crystallee Crain with Prevention at the Intersections. Complete this application to the best of your ability. Once your application is submitted you will receive a confirmation. Additionally, within two weeks you will get a response from Prevention at the Intersections about your acceptance in the program. Email preventionagenda@protonmail.com if you have any questions.

Email *

Full Name

Identities You'd Like to Share (Ex: gender expression, race, faith background) *

Phone Number *

Affiliations *

Describe your understanding of culture and/or identity. *

Share an experience when you learned something about the world from another persons perspective. *

How do you define community? Describe your experience working in community. *

What would you like to bring to the experience of the other Train the Trainers program participants? What qualities or expertise could you offer the group? *

What motivates you to facilitate trainings on Cultural Humility? How does this Train the Trainer program fit into your personal and professional journey? *

Resume/CV: Add you resume to google docs and submit the link below for our review. If you have a website you can include this as well. *

Are you able to pay the train the trainers fee?

Full Cost: $2500

50% Discount (only 2 available per cohort) $1250

100% Discount (only 1 available per cohort) $2500

Yes

I dont know

I need a partial scholarship(50% discount)

I need a full scholarship (100% discount)

Rate your comfortability with facilitation. 1 lowest, 5 the highest. (This will not impact your acceptance into the train the trainers program, we will train you on facilitation techniques.) *

Rate your comfortability with discussing topics of identity and culture. 1 lowest, 5 the highest. (This will not impact your acceptance into the train the trainers program) *

Please list any questions or comments you have for our team.

A copy of your responses will be emailed to the address you provided.

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