National Day of Racial Healing Registration

Thank you very much for your interest in the Bishop Arts Theatre Center’s  National Day of Racial Healing™ offering to eradicate the fallacy of racial human hierarchy. We look forward to seeing you on Monday, January 19, 20266:00pm - 8:30pm. Please complete the following information to register for the offering.

Sign in to Google to save your progress. Learn more
Email *
Phone Number *
Address/zip code *
First Name/Chosen or Given Name *
Surname/Family Name *
Age *
 National Day of Racial Healing™ methodology pairs people together to share connection through storytelling. Knowing your racial, ethnic, and gender identity will help us provide a meaningful experience for you and other participants.

What is your racial and ethnic identity? 
*
What is your gender identity?  *

Have you previously trained as an  National Day of Racial Healing™ co-facilitator? 

*
If you selected yes to the previous question, answer "With whom?"
Have you previously taken part in a healing circle? *
If you selected yes to the previous question, answer "where and approximately when?"

National Day of Racial Healing™ experience is 2.5 hours. It is important that participants are present for the full duration of the event? Can you participate for the full 2.5 hours? 

*
How Did You Hear About This Event? *
What are you hoping to experience or receive from this healing circle?
Do you have any needs or accommodations that would help you feel comfortable and supported during this event?
Any questions or comments? 

Highest Level of Education Completed *
Income Range 
*
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report