Waiting List: Train the Trainer Workshop: "Growing Economic Divide & the Racial Wealth Gap"

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**Registration for this workshop is currently full except for 8 slots for youth participants. If you are a youth participant, please fill out all of the information below. All others, please complete the below information to be placed on a waiting list. If you have any questions, please call Elly Porter-Webb at 215-851-1759 or email at epwebb@gpuac.org.

2 Day workshop: May 20th and 21st from 9-5 each day
United Way Building (17th and Benjamin Franklin Parkway)
*Lunch provided

First Name *

Last Name *

Organization/ Affiliation *

Email *

Phone Number *

Best Time to reach you at this number *

* The Presenter of the workshop would like to speak briefly with each participant before the workshop to get to know the group and mold the workshop around us.

Any Special Dietary Needs? *

How did you hear about this training? *

With whom do you plan to share (through formal training or informally) the information and training skills gained in this 2-day workshop? *

Payment

We want to make this workshop as affordable and accessible as we can. We ask that you please pay what you can.

Please pay what you can *

Sponsor: $200/ person

United Way Sponsored Student/ Staff

Sliding Scale: $60-$130 (Please Enter Amount in "Other" Box Below)

Other:

Please note that your registration will not be processed untill payment is received. Please email epwebb@gpuac.org if this poses a problem for you.

Please Make Checks out to Campaign for Working Families with your name in the Memo line and send to:

Economic Justice Coalition

c/o Campaign for Working Families

1207 Chestnut St. 5th Floor

Philadelphia, PA, 19107

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