“If you have come here to help me, you are wasting your time. But if you have come because your liberation is bound up with mine, then let us work together.”

– Lilla Watson

Event/Workshop Registration

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Once registered you will be added to CEI’s mail list for future communication. You may opt out at any time.

Select Training:

What type of event are you registering for?

Your Full Name (required)

Street Address (required)

City (required)

State (required)

Zip (required)

Phone (required)

Your Email (required)

Company (required)

Title (required)

Are you participating on behalf of an organization or company? YESNO

What do you hope to gain from this training?

Click here to read the Participation Waiver
I agree to participate

Click here to read the Refund Policy
I have read the Refund Policy

Why are you interested in this training and what do you hope to gain?(required)

Please identify groups, activities and/or trainings that you have led that advance equity and inclusion in your organization (and/or other spaces).(required)

Briefly describe how you identify racially and how that has impacted the way you work, including how you lead and facilitate equity and inclusion work.(required)

Please describe what it means to you to position yourself as a learner. Where and how do you anticipate this may be a challenge for you. What aspects of this type of participation are easy for you to embrace?(required)

Preferred Pronouns (required)

What racial/ethnic group(s) do you primarily identify with? (required)

Age

Specify your gender (required)

What racial/ethnic group(s) do you primarily identify with? (required)

Age

How did you hear about this event? (required)

How would you like to make payment?

Registering does not guarantee your acceptance into this session. Please look for communication from CEI staff in the coming week.

PAYMENT OPTIONS

To pay over the phone, please call Center for Equity and Inclusion at 503.451.3003. Please have credit card and billing zip handy. If we are unavailable, please leave a message and we will return your call by the next business day.

If you have questions about payment or would like to inquire about payment plans, please email info@ceipdx.org

Refund Policy

EDUCATIONAL EQUITY CERTIFICATE
PROGRAM APPLICATION

CLICK HERE TO REGISTER

Your Full Name (required)

Street Address (required)

City (required)

State (required)

Zip (required)

Phone (required)

Your Email (required)

Your District (required)

School (required)

SUBJECT/GRADE TAUGHT &/OR LEADERSHIP POSITION (AND YEARS):

HIGHEST LEVEL OF DEGREE/LICENSE/ENDORSEMENT CURRENTLY HELD:

The Equity Program is eight (8) graduate credits. Three (3) of these credits will directly transfer into the University of Portland’s Master’s program in teaching or certification programs for IAL, CAL, or endorsements. They may also be accepted by other educational institutions for transfer credit. Which option (if any) are you interested in?

SHORT RESPONSES

DESCRIBE YOUR REASON(S) FOR PURSUING PROFESSIONAL DEVELOPMENT IN EQUITY:

DESCRIBE YOUR PREVIOUS EXPERIENCE WITH EQUITY WORK:

ANY PROGRAM CONCERNS OR REQUESTS?

PROGRAM COMMITMENTS

1. I know the dates and times for the first two courses beginning August 7th and can attend all sessions (see “Equity Certificate Program” flyer).

2. I have reviewed the structure of the full year-long program and will complete all classes and related assignments/activities.

3. I know the credits will be awarded each term as earned but the Equity Certificate will be granted to eligible participants after completion of the entire program.

4. I know that transfer credits are linked between courses and I will have to complete the program to receive credits.

5. I know I will have to obtain any required books for the course (not to exceed six).

6. I intend to stay at my school site and lead for equity.

I have read the program reminders and can commit to each of them.
I agree

SIGN AND DATE

PAYMENT OPTIONS

CLICK HERE TO REGISTER

SHORT RESPONSES

PROGRAM COMMITMENTS

CONTACT

QUESTIONS?

LOCATION

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