Leadership & Racism Institute Registration

The registration fee for Just Organizations: Leadership & Racism Institute 2024 is:

$1,875 for EARLY REGISTRATION received by March 29, 2024, or
$2,075 for registration received by the FINAL REGISTRATION DEADLINE of May 17, 2024.

Registration fee is payable to: Educational Equity Consultants, 9378 Olive Blvd, Suite 206, St. Louis, MO 63132. Room accommodations are based on shared occupancy. Single rooms are available for an additional total cost of $195 for the three nights.

Name(Required)

First Last

School District / Organization

Title / Position

Work Address

Street Address Address Line 2 City State ZIP Code

Work Phone

Home Address(Required)

Street Address Address Line 2 City State ZIP Code

Cell Phone(Required)

Alternative Phone

Email(Required)

Dietary Needs

T-Shirt Size(Required)

Identity

Due to the nature of this retreat, the following information is required:

Sex(Required)

Female

Male

Racial Identity(Required)

Mini Essays

How do you see yourself as a leader?(Required)

How does your leadership challenge racism?(Required)

Emergency Contact Information

Emergency Contact Name(Required)

First Last

Emergency Contact Phone(Required)

Relationship to Emergency Contact(Required)

Single Room Request

A limited number of single rooms will be available that require advanced payment. The additional fee of $195 for the three nights needs to be received on or before May 17, 2024. The single room fee is fully refundable.

Payer for LRI 2024

Will you pay for the Just Organizations: Leadership & Racism Institute 2024 now, or should we invoice your district / organization instead?

Yes, I will pay for the LRI at this time. Please add it to my total below.

No, please invoice my District/Organization and they will pay for the LRI.

I prefer a single room for an additional cost of $195 for the three nights.(Required)

Yes, I want a single room

No, I do NOT want a single room

Payer for Single Room(Required)

Will you pay for the single room now, or should we invoice your district / organization to pay for the room?

Yes, I will pay for the single room at this time. Add it to my total now.

No, please invoice my District/Organization and they will pay for the single room.

Cancellation / Refund Policy
For cancelled registrations received on or before May 17, 2024, an amount of 50% will be refunded. For cancelled registrations received after May 17, 2024, there will be no refund.

Payment Information

LRI Registration (early)

Price:

Single Room

Price:

Total

Credit Card

Cardholder Name

Card Details

Just Organizations: Leadership & Racism Institute 2024 - Registration Form

Identity

Mini Essays

Emergency Contact Information

Single Room Request

Payment Information