Alert

Lorem ipsum
Okay
Logo

Online Course Sign-up

Please fill out this form to complete your sign up for Change the Game's online courses.

Online Course
Online Course Agreement
Please check the box below to acknowledge that you have read and agree to the Change the Game Online Course Agreement. You can find the document here: bit.ly/34CgxDk
How did you hear about this training?
  • Current Employer
  • Friends/Coworker
  • Listserve
  • Facebook
  • Linkedin
  • Campaign slack or volunteer network
  • Other
Please briefly describe why you are interested in this course.
  • {name}
Are you currently enrolled in a college, university or certificate program?
Are you currently employed?
How do you identify?
Please select as many as apply to you. Your answer will NOT affect your application or consideration for admittance.
  • Agender
  • Cisgender
  • Female
  • Male
  • Non-binary
  • Transgender
  • Other
  • Choose not to self identify
Please indicate your ethnicity
Peoples’ ethnicity describes their feeling of belonging and attachment to a distinct group of a larger population that shares their ancestry, color, language or religion. Please select as many as apply to you. Your answer will NOT affect your application or consideration for admittance.
  • Black, Afro-Caribbean, or African American
  • East Asian or Asian American
  • Latinx or Hispanic American
  • Middle Eastern, North African and/or Arab American
  • Native American or Alaskan Native
  • Native Hawaiian or other Pacific Islander
  • Non-Hispanic White or Euro-American
  • South Asian or Indian American
  • Other
  • Prefer not to answer
Are you able to pay the suggested donation for this course?
Instructions on how to donate will be emailed to you upon acceptance to this course. We strongly encourage those employed full-time to use professional development funds if possible. Assistance is at limited availability for those who need it.

Do not submit passwords through this form. Report malicious form