National Day of Racial Healing
Carbondale "At the Table" Dinner & Dialogue Event
About the Event:
This Carbondale "At the Table" Dinner & Dialogue event will be held on January 20th at the Carbondale Civic Center and recognize the National Day of Racial Healing. Doors will open at 5pm. From 5:30-7:00pm, community members from diverse backgrounds will engage in dialogue around a range of topics while enjoying a community meal. This event is free and open to the public. Seating is limited. Please fill out the form below to let us know you are coming and tell our host a little bit more about yourself. *Only your name and contact information are required. PLEASE NOTE- The additional demographic information requested is to assist with the grant reporting process. Please email Dianah McGreehan at dmcgreehan@carbondaleil.gov or call 618-457-3282 with any additional questions. To learn more about the National Day of Racial Healing visit dayofracialhealing.org.
About the Healing Illinois Initiative
Healing Illinois is a racial healing initiative by the Illinois Department of Human Services (IDHS) in partnership with the Field Foundation of Illinois and the Southern Illinois Community Foundation. The initiative targets community building and engagement designed to strengthen relationships and promote collective healing across communities.
Name
*
First Name
Last Name
Email (or phone number if preferred)
*
example@example.com
Current occupation
(Example: Teacher or Student)
What is the highest level of school you have experienced
Middle School
High School
College (Associates/Bachelors)
Graduate Level Courses
Professional Degree/Certificate
Age
17 years or younger
18-24
25-34
35-44
45-54
55-64
65 or older
Gender Identity
Woman
Man
Transgender/Trans Woman
Transgender/Trans Man
Non-binary
Prefer not to say
Other
Sexual Orientation
Heterosexual/Straight
Gay/Lesbian
Bisexual
Prefer not to say
Other
Preferred Pronouns
She/Her/Hers
He/Him/His
They/Them/Their
Prefer not to say
Other
Race/Ethnicity
Black/African American
Hispanic/Latino
White
Asian
Pacific Islander/Native Hawaiian
American Indian/Alaska Native
Two or more races
Prefer not to say
Would you be interested in serving as a facilitator/volunteer in the future?
Yes
No
Not at this time maybe in the future
Please list any dietary restrictions you have OR note none
If you are bringing any other guests, please indicate the number of guests you are bringing and/or provide their name(s)
Submit
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