When Things Go Wrong Online - May 8, 2024 - 6:00-8:00PM US ET

Registration - Contact Info

First Name *

Middle Name

Last Name *

Personal Pronouns (i.e. he/him, she/her, they/them, etc.)

Email Address *

Phone Number *

Work Phone Number

Address *

Address Line 2

Address Line 3

City *

State *

Postal Code *

Country *

Registration - Background Info

Organization/Group You Work With

Area(s) of Work *

Which issues or sectors do you work in? Choose all that apply.

Role(s) *

How best describes the role you play in social change? Choose all that apply.

Racial & Ethnic Identity *

Choose all that apply

Racial & Ethnic Identity (optional)

If selected "other" above or you wish to add more.

Class Background *

How would you describe your class background?

How will you apply what you learn in this training? *

Please let us know if you would like to request any of the following to ensure accessibility (Optional)

Live Closed Captioning (Auto CC is always available)

Sign Language Interpretation (please specify type below)

I will use a screen reader to read slides

Other. Specify below.

Is there anything else we should know about what would make this training more accessible for you? (Optional)

How did you hear about this training? *

Word of Mouth/Friend/Co-worker Newsletter Website Social Media Other

Who did you hear about it from?

If selected "other" above, how did you hear about the training?

Anything else you'd like us to know?