REGISTRATION
Date and Time: August 20, 2022 • 11AM to 4PM
Venue: Fresno City College, (Old Administration Building, Room OAB 188), 1101 E University Avenue, Fresno, CA 93741.
Contact us: sjvccc@actaonline.org
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Email *
Name *
Preferred pronoun(s)
Telephone *
City and Zip code *
How do you identify? (check all that apply) *
Required
Name of organization, if you identify as an organization leader or administrator.
Address of organization if different from above.
Is your organization a 501(c)3 nonprofit?
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Brief description of your work or practice - 150 words max (this will be used in the attendee directory).
*
Do you have any of these? (check all that apply)
If yes to any of the above, please share your links and handles here.
Dietary restrictions *
Required
If you need assistance at the gathering, let us know (language interpretation, ASL, wheelchair access, audio description, etc.).
Time will be reserved during our gathering for “Culture Sharing”. Any person or group that wants to share, will have no more than 5 minutes to share a bit of their culture practice or expression with the group. Will you be willing to share?
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If YES, tell us in one or two sentences what you plan to share.
Attendees may qualify for standard transportation expense reimbursement if attending from over 50 miles from event venue. If you will like to request transportation reimbursement, indicate your full address here.
A copy of your responses will be emailed to the address you provided.
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