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First Name
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Last Name
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Birth Date
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+
Gender
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Pronouns?
Click here
for description.
What is your race?
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What is your ethnicity?
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Organization
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Is your organization funded by the Legal Services Corporation?
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Yes
No
Title
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How many people work at your organization?
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Address 1
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Address 2
City
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State
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Zip
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Contact Phone Number
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Email Address
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How did you hear about RJI?
Please identify individuals who are applying as part of your equity team:
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References. List the names, phone and emails of two references familiar with your work. Reference 1 Name:
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Relationship
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Email
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Phone number
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Reference 2 Name
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Relationship
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Email
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Phone number
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Confirmation of Support. Upload your completed 'RJI 2021 - Executive Director Confirmation Letter' (format accepted is PDF). Letter can be downloaded
here.
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List two people at your organization--not applying as part of your equity team--who have the positional authority to provide critical support to this initiative. Please provide their name, title, and email address.
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In what Region do you work?:
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Northeast
Midwest
South
West
Hawaii
U.S. Territories
What current advocacy issues do you work on? (Pick up to three):
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Budget and Tax Justice
Child Welfare
Civil Rights
Criminal Justice
Climate Change/Environmental Justice
Consumer
Disability
Domestic Violence
Economic Justice
Education
Elder Law
Employment/Labor
Environmental Justice
Farmworker Justice
Health Care
Housing/Homelessness
Human Rights
Immigration/Immigrants’ Rights
Income maintenance/Benefits
Juvenile Justice
LGBTIQ Rights
Prisoner Rights
Re-entry
Reproductive Justice
Transportation
Voting Rights
Wage & Hour/Labor
Youth/Juvenile Justice
Other
Other
1. What experiences have you and your team members had working on racial equity issues? (If applicable, please share a link that illustrates any work you or your organization has done.)
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2. Who have been some of your community partners in working on racial equity issues and how do you work with them?
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3. What skills, strengths or success stories will you bring to this year's cohort?
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4. What specifically do you hope to learn or gain by participating in the Institute? How do you hope to apply what you learn from the Institute?
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5. Please tell us a bit about your proposed racial equity team: Do you have experience working together? How do you know each other? Do you have experience working with your co-applicants? What unique perspectives or strengths do individual team members bring to the group? What opportunities and challenges do you anticipate in working together?
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6. What initial thoughts does your proposed race equity team have for your team project scope?
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7. What challenges or opportunities do you anticipate in moving a race equity initiative forward?
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8. Are you able to fully commit—both individually and organizationally--to all of the participation requirements as described
on this webpage
? How will you adjust your current schedule to make time to fully participate?
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