Yes, I would like to participate in study circles on race and ethnic relations in Jacksonville, which the Jacksonville Human Rights Commission (“JHRC”) will be commencing in the Fall 2021. 

I understand that this is a voluntary process and that a study circles group (consisting of 8 to 12 participants and 1 to 2 facilitators) will meet for 2 hours per week over a period of 5 weeks.  JHRC will add my name to the list of interested persons and contact me when a study circles group becomes available.

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* 1. Name

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* 2. Phone number:

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* 3. Email address:

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* 4. Zip Code (in order to schedule a convenient location for participants):

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* 5. I am available for study circles meetings during the following time periods (please check all that apply):

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