Contact Information
Name
*
First Name
Last Name
E-mail
*
Phone
*
-
Area Code
Phone Number
Address
*
Street Address
Apt / Room / Suite
City
State
Zip Code
Organizational Affiliations
What organizations do you work for, are you a member of or volunteer your time with?
Organizational Roles / Titles
If not applicable, just type n/a.
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Demographic Information
The following questions are all OPTIONAL. We are committed to diversity, equity and inclusion in our work. Sharing this information helps ensure a strong representative cohort for the training.
Are you Indigenous, Native American or First Nations?
No
Yes
Do you identify as a Person of Color (POC)?
No
Yes
Race / ethnicity / tribe
Do you identify as a woman?
No
Yes
Do you identify as LGBTQ+?
No
Yes
Do you identify as disabled?
No
Yes
Do you identify as working class?
No
Yes
Are you or your parents immigrants to the U.S.?
No
Yes
Do you identify as a religious minority?
No
Yes
Religious affiliation
Do you live in a rural community or on a reservation?
No
Yes
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Military Service
Did you serve on or after September 11, 2001?
*
No
Yes
Branch and Years of Service
*
(e.g. USMC 2001 - 2006)
Other relevant service information
MOS, grade/rank, special assignments, duties, billets, awards and decorations, etc.
Proof of service
*
DD214, military or veteran ID card.
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Tell us more...
I would like to attend during the following retreat dates:
*
July 2020
Please inform me about future retreats
Why are you interested in attending the VOI? How do you see yourself using the skills from the training?
*
Tell us briefly about your past or current involvement in advocacy, civic engagement, or social justice work. What issues matter most to you?
*
How does your military service inform this work, and what role do you see for veterans in social change?
*
Any additional information you want to share about your life, work, education, etc?
How did you hear about this training?
*
Email
Facebook
Twitter
Other
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