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 on May 27-29, 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 $1,200 participant fee for one or $1,000 each for two or more participants registering at the same time. (Limited to 30 participants),

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* 1. Your contact info:

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* 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)

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* 3. Feel free to share parts of your identity that you'd like us to know about (for example racial identity(ies), sexual orientation, religious/faith background, gender/gender identity, class background, etc).

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* 4. We will be providing breakfast and lunch each day. What do you need us to know about your food needs? (vegan, vegetarian, gluten-free, allergies, religious/cultural, low-glycemic, etc.)

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* 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?

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

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

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

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

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

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

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* 12. How did you learn of PINK Institute?

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* 13. Given this is a workshop designed for individuals and teams of color, we'd like to know the dynamics of the differences and commonalities our participants have. Please share how you identify racially/ethnically ________________

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