Democracy & Belonging Forum Member Application

Thank you for your interest in joining the Democracy & Belonging Forum, an initiative of the Othering & Belonging Institute at UC Berkeley. Through in-person and online convenings, original research, story-sharing, funded joint experiments and other activities, Members of the Forum will evolve their understanding of the concepts of othering, belonging, breaking and bridging as they apply to different regions, and share practices and strategies to counter polarization and democratic erosion—all while grappling with the reality of power, privilege, and positionality in our diverse social and cultural contexts. Members of the Forum have exclusive access to: - Private gatherings - Public events - Peer-learning and resource exchange - and more Learn more about these Member benefits here: https://www.democracyandbelongingforum.org/activities Questions? Please contact: sara.grossman@berkeley.edu

First Name:

Last Name:

Gender Pronouns (Optional):

If you want to know more about why we are asking for your gender pronouns, please go to mypronouns.org

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Race / Ethnicity (Optional):

We seek to make the Forum as diverse as possible, so if you’re comfortable sharing, please let us know how you identify.

What organization(s) are you associated with?

Please provide website links.

Job Title(s):

Country of Residence:

Email:

Were you referred to the Forum by an existing member?

If yes, please specify who.

Briefly, what is your social change mission?

Max 100 words.

Issue(s) Focus:

Select all that apply. If "Other," please specify.

Sector:

Select all that apply. If "Other," please specify.

Briefly, are polarization and breaking across identity lines affecting your work? If so, how?

Max 500 words. Please watch this video if you are unfamiliar with our concepts of bridging and breaking: https://www.youtube.com/watch?v=MZjSsuz1yfA

Do you consider yourself a bridger? How comfortable are you engaging with people you disagree with or do not understand?

What are you looking to get out of or gain from the Forum? (Optional)

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What can you offer the Forum community? (Optional)

e.g. bridging skills, resources, networks, etc.

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Where did you hear about the Forum? (Optional)

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