Racial Healing Circle Request Form

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This form is for interested community members, groups, and organizations to request a customized racial healing experience, hosted by Battle Creek racial healing practitioners.

Racial healing is an individual and collective process that supports the dismantling of racism within ourselves and society. When grounded in empathy and oriented towards equity, racial healing has restorative potential and affirms our humanity and inherent value. This experience is a process and tool to facilitate trust and build authentic relationships that bridge divides created by real and perceived racial differences.

The Battle Creek Coalition for Truth, Racial Healing, and Transformation (TRHT) has provided professional development training and opportunities for a cohort of over 20 local racial healing practitioners. These racial healing practitioners create spaces for participants to share personal experiences and heart stories, leaving each circle with a deeper understanding of their own experiences and closer connections with others.

Goal for Racial Healing Circles: To open the hearts and minds of participants to more fully engage in relationships in the community across racial affinity and difference.

Objectives for participants:
- To participate in a customized racial healing experience grounded in TRHT practices and methodology
- To share personal experiences and heart stories
- To leave the circle in a deeper relationship with one another

To allow for deep reflection and powerful insights, each in-person circle is limited to 25 participants and virtual experiences are limited to 16.

Information shared via this form will be maintained privately by a BC TRHT Coordinator. A BC TRHT representative will contact you shortly to schedule a phone call or Zoom meeting to discuss this opportunity and your responses. If you have any questions, you may contact a BC TRHT representative at info@bctrht.org

Thank you for submitting your request! A copy of your responses will be e-mailed to you immediately.

Email *

Your Full Name: *

Name of your Organization/Group: *

Your Title:

Your Phone Number: *

Indicate all of the statements that are true for you: *

We are interested in a 1.5 hour virtual racial healing experience

We are interested in a 2 hour in person racial healing circle

We are interested in a series of 2-6 circles/experiences

I am not sure yet what our specific interests are for the racial healing experience

Other:

Required

For transparency, Battle Creek TRHT offers a sliding scale fee structure to host customized racial healing experiences. Please select the option that most closely aligns with your organization to indicate the associated cost:

My organization's annual operating budget is...

$50,000 or less: Cost would be $200 / experience (amount covers the practitioners’ time)

$50,000 - $250,000: Cost would be $600 / experience (amount covers practitioners’ time, some of coordinators’ time)

$250,000 - $500,000: Cost would be $1,100 / experience (amount covers practitioners’ time, coordinators’ time, and overhead)

$500,000 - $1 million: Cost would be $1619 / experience (amount covers practitioners’ time, coordinators’ time, overhead, and sponsorship for a future public or nonprofit circle)

Over $1 million: Cost would be $1865 / experience (amount covers practitioners’ time, coordinator’s time, overhead, and sponsorship for a future public and nonprofit circle)

I have a unique circumstance that I will describe under "Other"

Other:

Required

Preferred date for in person circle or virtual experience to take place: *

Please share a brief description of the background and your goals for this request: *

How did you hear about this opportunity? *

Word of mouth

TRHT website

TRHT event

National Day of Racial Healing

From a printed flyer

Other:

Please share any additional comments for the organizers.

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

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