Institute of Impacted Leaders Interest Form
Please fill out this form if you are interested in participating in Initiate Justice's Institute of Impacted Leaders - a 12-week organizing training program designed for people directly impacted by mass incarceration! Please fill out this form to join our second cohort - one in LA and one in Oakland - from July - October 2019. Sessions begin Tuesday, July 16 for Oakland and Wednesday, July 17 for LA at 6:30pm.
Email *
First & Last Name *
Phone Number *
City *
Are you interested in the Los Angeles or Oakland Cohort? *
How are you impacted by mass incarceration? (Check all that apply) *
Required
Tell us more about yourself and how mass incarceration has impacted your life (3-5 sentences). *
Why do you want to join the Institute of Impacted Leaders? *
What is your vision for ending mass incarceration? (3-5 sentences). *
The Institute trainings will be held on Tuesday evenings (in Oakland) and Wednesday evenings (in LA) from 6:30-9:00pm from July - October 2019. Does this date / time work for you? *
Can you attend the Institute Info Session on Tuesday, July 16 (Oakland) or Wednesday, July 17 (LA)? *
In order to graduate from the program, you will be required to miss no more than 2 sessions AND attend an advocacy day in Sacramento (or do an in-district lobby visit). Can you commit to these requirements? *
What support might you need to make it easier for you to participate in the trainings, such as transportation support, childcare, etc.?
Do you have any other questions?
A copy of your responses will be emailed to the address you provided.
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