PINK Institute Advance Intercultural Leadership Development & Healing POC Event Registration - November 2020

Thank you for your interest in attending PINK Institute Advance Intercultural Leadership Development. Please complete the following application to participate in PINK Institute Intercultural Leadership Development & Healing on November 4-6, 2020. The focus of this session will be intercultural leadership development. We would like learn a bit about you, your goals for attending, and how you might use this work. In addition, we are asking some identification questions because we intentionally want to foster an intentionally diverse learning community.

Once your application is accepted, we will send you payment options for the $1,000 participant fee for one or $800/each for 2+ participants. (Limited to 30 participants)

Question Title

* 1. Your contact info:

First Name

Last Name

Job title

Organization

Address

Age

Email Address

Phone Number

Question Title

* 2. We do not make assumptions about gender identity based on presentation; please share your pronouns (for example: they, she, he, I prefer you just use my name)

Question Title

* 3. We know racial identity can be complicated; however, this journey is specifically designed for participants who identify as a person of color. Please share your racial/ethnic identity so we know who's represented in our learning community.

Question Title

* 4. We will be serving continental breakfast each morning, what do you need us to know about your food needs?

Question Title

* 5. We want to ensure an accessible learning environment. As we select meeting rooms and plan content, what do we need to know about your physical/cognitive needs and abilities? Put another way, what would help you do your best learning?

PINK Institute Advance Intercultural Leadership Development & Healing POC Event Registration - November 2020

Question Title

* 1. Your contact info:

Question Title

* 2. We do not make assumptions about gender identity based on presentation; please share your pronouns (for example: they, she, he, I prefer you just use my name)

Question Title

* 3. We know racial identity can be complicated; however, this journey is specifically designed for participants who identify as a person of color. Please share your racial/ethnic identity so we know who's represented in our learning community.

Question Title

* 4. We will be serving continental breakfast each morning, what do you need us to know about your food needs?

Question Title

* 5. We want to ensure an accessible learning environment. As we select meeting rooms and plan content, what do we need to know about your physical/cognitive needs and abilities? Put another way, what would help you do your best learning?

Question Title

* 6. Have you taken the Intercultural Development Inventory (IDI) before? If yes, how recently?

Question Title

* 7. Tell us about your interest in attending this workshop?

Question Title

* 8. What is one leadership challenge you are experiencing in your work/community as it relates to race and culture?

Question Title

* 9. What is one leadership opportunity you are experiencing in your work/community as it relates to cultural dynamics?

Question Title

* 10. How do you plan to utilize the information and skills learned during this workshop?

Question Title

* 11. This workshop will be most successful if...

Question Title

* 12. How did you learn of PINK Institute?