Undivide Us Application

Thank you for filling out this application to participate in “Undivide Us: An Invitation to Dialogue across Difference.” Applicants will be notified of acceptance and assigned workshops by Dec. 30.
1.What is your first and last name?
2.What is your email address
3.What is your phone number
4.What town do you live in
5.The dialogue circles are scheduled to be held from 8:30 a.m. to 1 p.m. on Jan. 17, 24 or 31 (2026). Please select the date or dates below on which you could attend.
6.What is your occupation(s); if retired, indicate with (R) and then list prior occupation, if student list field of study
7.Select up to three of the following descriptions of social and political priorities that are MOST appealing to you
8.How would you define your political worldview?
9.Why are you interested in attending this event? (250 words or less)
10.What political, social, or policy-related issues or problems are you most concerned about in the United States today? (i.e. Crime reduction, poverty alleviation, climate change) Please list 3 issues.
11.Do you have anything else you would like to add that you think we should take into consideration?
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