PURCHASE ADMISSION TICKET PLEASE FILL OUT THE FORM BELOW Name * First Name Last Name Email * Phone (###) ### #### Do you need access to an ADA entrance? * Yes No Workshop Choice #1 * Criminal Justice Affordable Housing Immigrant Rights Dismantling White Christian Nationalism Healthcare: Access & Equitable Care Reparations Workers Rights Voting Rights Workshop Choice #2 * Criminal Justice Affordable Housing Immigrant Rights Dismantling White Christian Nationalism Healthcare: Access & Equitable Care Reparations Workers Rights Voting Rights How did you hear about the Racial Justice Summit? * Attended Last Year A friend/family member Flyer Social Media An Organization Other Do we have permission to take photo and video footage of you during this event? * This content will be used for our social media and other promotional materials in the future. Yes No Do you have any additional questions/concerns? * Thank you!We look forward to seeing you at The Racial Justice Summit!
