REI RSVP

Racial Equity Institute Workshop

PHASE I
This is a Two-Day workshop designed to help community members and organizational leaders to understand and address racism, both in their organizations and in the community.

The workshop will provide the basis for understanding and addressing racism and its history along with tools for future discussions to proactively work toward dismantling racism.

*Mandatory to attend both days

Question Title

* 1. Have you attended a Racial Equity Insitute workshop before?

Yes

I don't know

Question Title

* 2. What Healthier Together community are you affiliated with? SELECT ALL THAT APPLY

Healthier Jupiter

Healthier Delray Beach

Healthier Neighbors

Healthier Boynton Beach

Healthier Lake Worth

Healthier Glades

Other Palm Healthcare Foundation affiliation

Question Title

* 3. Which community role best describes you? SELECT ALL THAT APPLY.

Community Member/Resident

Provider

Community Leader

Other (please specify)

Question Title

* 4. Which race/ethnicity best describes you? SELECT ALL THAT APPLY.

American Indian or Alaskan Native

Asian / Pacific Islander

Black or African American

Hispanic

White / Caucasian

Other (please specify)

Question Title

* 5. Please provide your contact information

First Name

Last Name

Organization/Company

Position

Email Address

Phone Number