Scholarship Registration Form

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Please join the URJ team for a transformative five-week community and capacity building experience to support your quest to join the movement for racial justice. This course is designed for white people who are new to this work and are looking for ways to effectively engage this work as an ally and accomplice-in-becoming.

Attendance is required for the entirety of all five (5) sessions, and payment is nonrefundable (except in the case of emergencies).
We'll be offering multiple rounds of this course, so if these days/times don't work for you, reach out to us.

The payment structure for this course with scholarship funding is sliding scale: $25 - $125 ($5-$25 per week). You will receive a payment link in your confirmation email.

NOTE: Please email us if you do not receive a confirmation email immediately after completing this form. You may need to check your "spam" folder.

. We look forward to being together in this learning community with you soon!

Please submit this form by March 06.

Follow-up payment due by March 06.

If you have any questions, please contact our URJ team at programs@titletrackmichigan.org.

About you:

* First name

* Last name

* Pronouns

* Email

* Phone

Do you have any access needs that you would like us to be aware of?

What county and state do you live in?

* Would you like to subscribe to the Title Track newsletter?Yes, please!No, thanks

Which business or organization (if any) are you primarily affiliated with in your community?

* Are you able to attend all five live sessions and complete an additional weekly hour of learning and reflection during this course?Yes

* On a scale of 1 to 10, with 10 being the highest, how would you rate your understanding of racial issues in white supremacist culture?

* Why are you saying YES to this introductory training on racial justice and white ally/accompliceship, and/or what questions are you hoping to address?

* On a scale of 1 to 10, with 10 being the highest, how would you rate your community engagement with anti-racist advocacy, within your friends and family circles?

* Within the greater community?

Is there anything else you would like us to know about you or your participation in this program, including potential obstacles to participation?

Oops! You've missed a required question.

Thank you for your connection to and support of our mission to engage creative practice to build resilient social-ecological systems that support clean water, racial equity, and youth empowerment.

Title Track is a registered 501(c)(3) nonprofit with the Federal Tax EIN of 38-2742032.

No refunds will be issued if cancellation occurs less than 14 days before the first class, except in cases of emergency.