eGRF 2021 Member Registration Form
Thank you for your interest in the New York Center's online group relations event, United and Divided We Stand: Leadership, Authority, Political Identity, and ________.
Save the date: Saturday, February 20, 2021 (9:00 am - 4:00 pm EST)
Please complete this form by Saturday, February 6, 2021, to register your interest. Space is limited. To preserve the integrity of the event, participants are expected to attend all sessions. All information shared will be kept confidential.
DISCLAIMER: Experiential learning of this nature may be stressful. If you are experiencing undue stress in your life (for personal reasons), we advise that you reconsider attending.
with any additional queries.
Are you a member of the New York Center?
Do you have prior group relations experience?
If other, please explain.
Where do you live?
If in the US, which state? And if outside the US, which country?
What is your political party affiliation and/or political ideology?
What is your nationality? Or nationalities?
What are your pronouns?
What is your sexual orientation?
How do you identify racially?
What is your ethnicity?
Is there any other identifying information you would like to share (e.g., class background, military service, disability, religion, and/or parental status, etc.)?
Do you know anyone attending the event as a member or on staff?
If yes, please name.
Do you require accommodations (e.g., Closed Captioning)?
If yes, please describe.
Please fill in the blank: "United and Divided We Stand: Leadership, Authority, Political Identity, and _________"?
What resonates with you? Answers will be anonymized.
Please consider paying at the highest rate that you can afford: your generosity supports our delivery of a sustainable event in service of equity and opportunity. Select one of the fee options below. We will then follow up via email to confirm your payment.
Full fee - $75
Reduced fee (NY Center Member) - $50
Reduced fee (Non-student) - $50
Student fee (2020/2021) - $25
What happens next?
We will (1) contact you via email to pay your registration fee and (2) provide more information in preparation for the event.
Send me a copy of my responses.
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