Register to Become a Participating Site

The deadline to sign up is Thursday, April 23rd, 2015. Organizations that sign up after this deadline will still be listed as a Participating Site but will not receive a toolkit in the mail.

 

To register fill out all fields below. Fields marked with an * are required.

 

Organization Info
 
Name of Organization: *
Contact First Name: *
Contact Last Name: *
Address Line 1: *
Address Line 2:
City: *
State: *
Zip Code: *
Web Site:
Twitter Webpage URL:
Facebook Webpage URL:
 

If you are not a YWCA, do you have a working relationship with a local YWCA association?

Please Choose: *
If "Yes", which one?
 

How did you hear about the Stand Against Racism?

Please Choose: *
 

If you have previously participated in the Stand Against Racism, please list the years of participation below:

Years of Participation:
 
Event Address (This will be the address that will appear on the web site.)
 
Address Line 1: *
Address Line 2:
City: *
State: *
Zip Code *
Phone Number: * (format as 555-555-5555)
 
Access Credentials
 
Email Address: *
Password: *
 
Registration Details
 

Will your Stand be Public (open to the public and your constituents) or Private (for your constituents only)?

Please Choose: *


What is the Date and Time of your Stand? (You must choose at least one date)

Thursday, April 23, 2015 From Time     to Time  
Friday, April 24, 2015 From Time     to Time  
Saturday, April 25, 2015 From Time     to Time  
Sunday, April 26, 2015 From Time     to Time  

 

Other information you would like participants to know about your Stand? (For example: the name of your speaker, parking information, other event-specific information that you would like people to know). This information will be displayed on our Web site:

 

 
Verification
 

Verification Code:

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