CCORR Train-the-Trainer Application

Name(Required)

First Last

Phone(Required)

Email(Required)

Please enter your age(Required)

Please select your Race/Ethnic background(Required)

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

White

Do you have any disAbilities that you want us to know about?(Required)

Yes

Please list your disAbilities here.

Are you clergy or laity?(Required)

Feel free to add additional descriptors like retired, appointed, working full/part-time, or self-employed.

Please type your church name (and city if necessary)(Required)

Please select the district your church is in.(Required)

For what reason(s) are you applying to become a Diversity and Inclusion Trainer? Please be specific.(Required)

Are you available for in-person training on Aug. 5-7th?(Required)

The training will be held at First Mesa UMC if everyone is open to an in-person gathering.

Yes

First UMC of Mesa is following their opening guidelines per the terms submitted to the Annual Conference. Please be aware of your own risk factors for attending the in-person training. Wearing masks as appropriate, especially for those individuals not fully vaccinated, and following social distancing, guidelines are expected for all persons who attend the training.

Do you have experience in the following?(Required)

When you select the items you have experience in, a text box will pop up below this question so you can elaborate.

Cross-Cultural/Cross-Racial Initiatives

Leading Small Groups

Teaching

Public Speaking

Co-facilitation of Small Groups / Trainings

N/A

Please elaborate on your experience in Cross-Cultural/Cross-Racial Initiatives.

Please elaborate on your experience with Leading Small Groups.

Please elaborate on your teaching experience.

Please elaborate on your experience with Public Speaking.

Please elaborate on your experience with Co-facilitation of Small Groups / Trainings.

What are your thoughts on "diversity and inclusion" as they relate to the Church?(Required)

Please describe any of your work related to equity, social justice, or intercultural relations.(Required)

Please provide any additional information you believe relevant to the Diversity and Inclusion Trainer position.

Phone

This field is for validation purposes and should be left unchanged.

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