Application: How to Teach Strategy | Training for Change Powerbase

Contact Information

First Name *

Last Name *

Organization/Group Name

Email *

Phone Number *

What issues/sectors do you work in? *

Which roles describe you? (Please choose 1-3 that best describe(s) your role) *

Staff/leader of an organization

Member of an Organization or Group

Trainer/Educator

Base-builder/Organizer

Academic/Scholar

Artist/Performer

Healer/Spiritual Leader

Activist

Background

What are your top learning goals (1-3) in attending this workshop? *

Where or how will you apply what you learn at this training? *

Give an example of an upcoming training or workshop you will or might lead. *

Logistics

The workshop will be held in central West Virginia on a campus. All on-site lodging and meals are covered by the registration fee. We cannot pay for personalized off-site lodging or cover off-site meals.

I would like to... *

Stay in lodging on campus

Commute

Commute and offer my home as a home-stay

Get support finding a home-stay

Find and pay for my own lodging

Dietary Preferences. Choose all that apply. *

Meat

Vegetarian

Vegan

Gluten Free

Dairy Free

Additional Dietary Needs (optional)

Anything else you'd like us to know? What requests do you have with regard to ability and mobility?

Fee: How much can you pledge to contribute toward registration, if your application is accepted? *

Our trainings fees are sliding scale, with suggested fees based on income, to make them accessible. Choose the fee that matches your income or that represents what you're able to contribute at this time toward registration. If you are being sponsored by an organization, use the organization’s budget as a substitute for income. Fees cover basic expenses such as space rental, food, printing handouts, and modest stipends for trainers and logistics support. If you have questions about fees, please email Katey at wvtrainersproject@gmail.com.

$100 (income under $15,000)

$150 (income $15,001-$25,000)

$200 (income $25,001-$35,000)

$250 (income $35,001-$45,000)

$300 (income $45,001-$55,000)

$400 (income over $55,000)

Do you wish to apply for a scholarship that would cover your registration fee? *

Yes

Thanks, we'll be in touch with you about your scholarship request.

If granted a scholarship, how much can you contribute toward the cost of registration? *