Common Good Intensive Interest Form
Thank you for your interest in the Common Good Intensives. We know these topics, as well as the dynamics they can create inside organizations, are often sensitive and complex. We'll ask for some detail about what's been happening so we can figure out the best way to support you. There's no wrong way to describe what you're experiencing, and no language you need to have figured out beforehand. If more than one person from your organization would like to attend (we encourage this, up to 3 total!) please note that each person will need to fill out the interest form individually. All responses are completely confidential and will only be shared with our facilitation team. This platform is encrypted.
Basic Info
Name
*
First Name
Last Name
Pronouns
Email
*
example@example.com
Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
City
*
State
*
Organization/Coalition Name
*
Organization Location (if different from yours)
Your Title/Role
*
Length of time in this role
Referred by
Organization Info
What kind of work do you do?
*
Grassroots organizing/Coalition-building
Advocacy/Social Services/Non-profit
Philanthropy/Fundraising
Civil service/Government official
Clergy/Community leadership
Other
Do you work locally, regionally, nationally, or internationally?
*
Please Select
Locally
Regionally
Nationally
Internationally
Multiple levels
Please share a brief description of your organization’s work (e.g. a mission statement). This can be taken directly from existing materials, like a website or grant report.
*
What issues/dynamics/tensions are you currently navigating in your organization?
Israel/Palestine
Zionism & anti-Zionism
Muslim Identity & Islamophobia
Jewish Identity & antisemitism
Christian identity & expression
Race & Racism
Whiteness
Anti-Blackness
Organizational dynamics (e.g. ineffectual leadership, challenging culture, etc.)
Other
In your own words, describe the specific challenge or situation that's bringing you to this interest form. What are you navigating, and what feels urgent?
*
Please tell us about where these tensions are primarily showing up? (e.g. between colleagues/peers within an organization, between managers/leadership and other employees, between you and your coalitional partners, etc...)
*
What has been your primary relationship to these tensions? (e.g. actively involved, passively observing, working to mediate, caught in the middle, etc...)
*
How long has your organization or coalition been dealing with these dynamics?
*
Just emerging
6 months or less
1–2 years
Ongoing for several years
How knowledgeable do you consider yourself on the history, tropes, and current manifestations of following issue areas? 5=Extremely knowledgable, 1= very limited knowledge.
*
Rows
1
2
3
4
5
Antisemitism
Islamophobia
Anti-Blackness
White Nationalism
Christian Nationalism
Please describe your personal relationship to these issues broadly (as relevant).
What would it look like for this intensive to be genuinely useful to your work? What are you hoping to bring back?
*
Is there anything else you'd like us to know about your situation or what you're looking for?
Availability and Fee Coverage
August 3th-4th (Washington, DC) availability
*
Yes, I’m available both days
I’m available one day only
No, I’m not available
Other
September 15th-16th (Minneapolis) availability
*
Yes, I’m available both days
I’m available one day only
No, I’m not available
Other
December 7th-8th (Los Angeles) availability
*
Yes, I’m available both days
I’m available one day only
No, I’m not available
Other
I would prefer to attend
*
August 3th-4th in Washington, DC
September 15th-16th in Minneapolis, MN
December 7th-8th in Los Angeles, CA
We are asking organizations with financial means to cover a fee of $350 for the first participant and $150 for every additional participant from the same organization (up to 3 participants total). Do you anticipate that your organization will be able to cover this fee?
*
Yes, we can cover this fee
Not sure, I need to check
We can cover a portion of this fee
No, we cannot cover this fee
Participants and their organizations will be responsible for transportation costs to and from the intensive. However, we are committed to accessibility and will be providing travel stipends to anyone for whom this cost poses a barrier. Do you anticipate needing a travel stipend?
*
Yes, I will require a travel stipend
Not sure, I need to check
We can cover a portion of travel costs
No, I will NOT require a travel stipend
Is there anything else you would like to tell us about your availability or ability to attend?
Submit
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