2019 AWARE-LA Summer Institute - Unmasking Whiteness
Registration Form and Participant Information Sheet

July 25-28, 2019, The Wesley School, 4832 Tujunga Avenue, North Hollywood, CA, 91601

Total cost for institute is $200 when deposit or registration payment is received by March 31st. After March 31st, total cost is $225. This fee includes seven workshops and 3 lunches.

Receipt of a $50 deposit (along with submission of this form) will finalize your registration and hold your spot. A receipt will be emailed to you to confirm your registration and payment. Any balance remaining is due upon arrival for the institute on July 25th.

There are two ways to make payments, by check or Venmo.

If making a payment via check, make check payable to: Unity Bridges (our non-profit fiscal sponsor)
Send checks to the following:
Unmasking Whiteness Institute
c/o Shelly Tochluk
Education Dept./MSMU
10 Chester Place
Los Angeles, CA 90007

If making a payment via Venmo, search for "Unity Bridges" and in the area that asks, What's it for? Please put either "Institute deposit" or "Institute registration." Once completed, alert Shelly Tochluk at stochluk@msmu.edu that a payment has been made.

Scholarships: A limited number of partial scholarships are available for individuals without institutional funding. If you would like to be considered for a scholarship, please submit a letter of request explaining both 1) why you should be considered for this scholarship and 2) the amount you are able to contribute to the registration cost. Send letters of request to stochluk@msmu.edu.

Logistics: Information including directions and a list of suggested accommodation options will be emailed upon receipt of registration and deposit.

* Required

Email address *
Name *
Your answer
Phone *
Your answer
Organization/Affiliation
Your answer
Please hold my place. *
Food Considerations: Three lunches (Th, Fri, and Sat) will be provided. Please note any dietary restrictions.
Your answer
Do you have any accessibility needs we should be aware of to ensure that you can participate as fully as possible?
Your answer
Participant Application
Please fill in answers to the four questions below to allow us to get to know a bit about your experience. This will help us prepare for the institute. Thank you for your honesty!

1. When did you first realize that being white made a difference in your life? What happened? *
Your answer
2. What does it mean to you to be a white person at this time in your life, and how do you feel about it? *
Your answer
3. In what ways do you practice anti-racism? *
Your answer
4. In what ways do you hope this institute helps you to grow? *
Your answer
Please tell us, how did you hear about this institute? (mark all that apply)
Would you like to be more specific? Who offered you the info or where did you receive it? (We like to track our outreach efforts)
Your answer
Final reminder:
Your registration is not complete until your deposit is received.

If sending a check, make check payable to: AWARE-LA
Send checks to the following:
Unmasking Whiteness Institute
c/o Shelly Tochluk
Education Dept./MSMU
10 Chester Place
Los Angeles, CA 90007

If making a payment via Venmo, search for "AWARE WPforBL" and in the area that asks, What's it for? Please put either "Institute deposit" or "Institute registration." Once completed, alert Shelly Tochluk at stochluk@msmu.edu that a payment has been made.

Contact Shelly Tochluk at stochluk@msmu.edu if you have any questions.

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