Cultural Humility Class Registration Registration Information Please complete the following registration information to sign up for the Cultural Humility Class. OK Question Title * 1. First name and last name OK Question Title * 2. E-mail address OK Question Title * 3. Phone number OK Question Title * 4. Affiliation(s) (check all that apply) AmeriCorps College Access Corps Western Washington University AmeriCorps VISTA Other AmeriCorps program Other (please specify) OK Question Title * 5. Brief description of the communities or demographic groups you work with or plan to work with. OK Question Title * 6. How did you hear of the class? Campus Compact Colleague Website E-mail Social media Other (please specify) OK Question Title * 7. Are you interested in Continuing Education credits? Yes No Other (please specify) OK Question Title * 8. Please tell us how you may be applying what you learn from this training Healthcare profession Teaching others Policy development Public service Other (specify) OK Question Title * 9. Please tell us what languages other than English you speak (if applicable). OK DONE