GARE Minnesota 2018 Racial Equity Learning Year Application Please respond to these questions to register for the GARE MN 2018 Racial Equity Learning Year. OK Question Title * 1. Who is completing this application? First Name Last Name Title Jurisdiction OK Question Title * 2. What GARE MN cohort will your jurisdiction participate in? (check all that apply) Introductory Cohort Implementation Cohort OK Question Title * 3. Our Introductory cohort team will be comprised of... ....6-10 participants ....11-14 participants ....15-17 participants Other (please specify) OK Question Title * 4. Our implementation cohort team will be comprised of... ....6-10 participants ....11-14 participants ....15-17 participants Other (please specify) OK Question Title * 5. Our Introductory Cohort team represents... ....our entire jurisdiction ....a department(s) Which department(s) will participate? OK Question Title * 6. Our Implementation Team represents... ....our entire jurisdiction ....a department(s) Which department(s) will participate? OK Question Title * 7. Our Jurisdiction is a GARE member Yes No We have applied for GARE Membership What date did you apply for GARE membership? OK Question Title * 8. Our jurisdiction is interested in GARE membership Yes Not at this time Please send me GARE membership information OK Question Title * 9. Who will receive and approve the 2018 MN Cohort invoice? First name Last name Title email address Phone Street Address Address 1 Address 2 City Zip OK DONE