YWCA Madison

Racial Justice Committee Interest Form

If you are interested in being a part of the 2017 Racial Justice Summit Committee please complete this form.
* required information
Racial Justice Summit Committee Interest Form 
Contact Information
First Name:*
Last Name:*
Email:*
Preferred Phone:
Race/Ethnicity (Check all that apply): African American/Black
Alaskan Native
Asian
Latino/a or Hispanic
Native American
Pacific Islander
White
Multiracial
N/A
Multiracial
White
White/Hispanic
Asian American and White American
Hmong
White/Black
Latino/a or Hispanic
Native American
Black, White, Mexican
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