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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.
Jan. 17, 2026
Jan. 24, 2026
Jan. 31, 2026
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
Focused on free enterprise, traditional family values, individualism and a strong national defense.
Focused on providing benefits and support for the middle class through government intervention on issues such as higher education support, strong labor unions, and a high minimum wage.
Focused on social progress for women, minorities and other marginalized populations and higher government spending on services, within our current capitalist system.
Focused on creating the maximum amount of personal freedom and choice with the least amount of government intervention possible in economic and social matters. Preventing the government from telling what we can and cannot do.
Focused on putting American interest first, stopping illegal immigration, ending unfair trade deals, and re-establishing America as the dominant global force.
Focused on everyday people and holding elites accountable for their actions and to the same rules and standards as everyone else.
Focused on challenging societal norms, promoting inclusivity, and addressing issues of discrimination and inequality through activism.
Focused on advocating for equality, fairness and the eradication of systemic barriers that impact marginalized communities.
Focused on breaking up big businesses, guaranteeing jobs, education and healthcare through mandatory government systems and championing social justice.
8.
How would you define your political worldview?
Conservative
Liberal
Progressive
Libertarian
Moderate
Anarchist
Other (please specify)
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?
Send me a copy of my responses via email
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