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Organizational Equity Practice Intake
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* Indicates required question
Date
*
MM
/
DD
/
YYYY
Organizational Background
Organization Name
Your answer
Full Organization Address
Your answer
Primary Contact Full Name
Your answer
Primary Contact Position
Your answer
Primary Contact Email
Your answer
Primary Contact Phone Number
Your answer
Please summarize the mission and work of your organization
Your answer
What communities/groups do you serve?
Your answer
Please share any partners you have been working with to support your efforts related to racial equity, restorative justice, and trauma inclusive practices:
Your answer
Select from the list below the type of training or engagement requested. Please take the above recommended guidelines into account when selecting the type of training requested:
Healthy Community Assessment
Organizational consulting and coaching
Training series
White Supremacy Culture 101 training
Equity 101 training
Cross organizational cohort pilot
We're not sure what we need
Other:
If any, what was the preceding incident that led to this request?
Your answer
Has your organization experienced any recent major changes? If so, please explain. (e.g. leadership transitions, turnover, etc.)
Your answer
Have you worked with Trinity before? If so in what capacity?
RELC
Racial Equity Leaders Circle
Emerging Leaders Circle
One off training
Workshop series
Recurring series
I have not worked with OEP before
Other:
Organizational Overview
What category best describes your organization?
Youth Serving
Community Health
State or City Government
School
Foundation
Faith Based
For profit organization
Other:
Clear selection
What is the size of your organization?
under 20 employees
between 20-50 employees
between 50-100 employees
over 100 employees
Clear selection
How many employees will be participating in this engagement?
Your answer
If any, what existing racial equity, trauma inclusive, or restorative work is taking place at your organization?
Your answer
Organizational Structure
Please describe your organizational structure. For example, do you have a leadership team?
Your answer
How would you describe the diversity of the staff? This can apply to diversity of race, ethnicity, gender, age, sexual identity, etc.
Your answer
How would you describe the quality of relationships across your organization?
Your answer
How often does your organization have all staff gatherings?
Never
Once a week
Once a month
Twice a month
Clear selection
What days do all staff gatherings typically occur?
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Clear selection
Planning and Budgeting
What specific knowledge and/or skills are you interested in acquiring through this engagement? (e.g. more self-awareness around white privilege, how to support staff of color, how to step back etc.) How will the acquired knowledge or skill help improve your organization’s performance?
Your answer
Who is your audience for this training? Front line/direct service/executive staff/board/management members?
Your answer
Will anyone from your organization’s leadership participate in the engagement training? If yes, please specify their level of involvement. If not, please share how participants will be supported by leadership to utilize the learning following engagement training completion:
Your answer
What are your preferred dates/times for training/engagement?
Your answer
How many people will attend the training/engagement?
Your answer
Are there any special needs (hearing, vision, mobility, interpretation etc.) for this training/engagement?
Your answer
When does your fiscal year start?
Your answer
When do you start budgeting your fiscal year?
Your answer
What is your organization's annual budget?
Less than $1 million
Greater than $1 million but less than $5 million
$5 million to $10 million
Greater than $10 million
Clear selection
What budget does your organization currently have available to support work related to racial equity, restorative justice and trauma inclusion?
Your answer
Do you give us permission to share in our newsletter and other materials that your organization is a client of our practice?
Yes
No
Maybe/need more information
Clear selection
Submit
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