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2024-25 Racial Equity Roundtable Application

General Information

Thank you for your interest in the upcoming Racial Equity Roundtable cohorts!

The three-hour sessions will take place one Friday morning a month, beginning October 2024 and ending May 2025. Specific dates will be determined as cohort rosters are confirmed.

We look forward to learning and advancing positive change with you.

40%

1.Organization Info

Institution Name

Organization Address (including City, State and Zip Code)

Phone Number

Website

CEO/President/Executive Director

Annual Operating Budget/Revenues

2.Primary Staff Contact for Racial Equity Roundtable

Name

Title

Phone Number

Email Address

3.Racial Equity Roundtable Participants

Name

Title

Email Address

Name

Title

Email Address

4.Substitute Participant(s)

Name

Title

Email Address

Name

Title

Email Address

5.Mission Statement or Business Purpose

6.Institutional Type (Check Primary Category)

Corporate or For-Profit Business

Nonprofit (Service Provider)

Government or Public

Philanthropic/Grantmaker

Health Institutions

Pre-K to 12 Education

Higher Education

Other (please specify)

7.Please choose your org's preferred cohort type (you may choose up to 2):

Cross-Sector (various institutional types)

Health Systems

Arts & Culture

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