2009 SFA Encuentro Application

Registration form for the 2009 SFA Encuentro
Immokalee, Florida | September 10-13, 2009

Name (First & Last):*

Email:*

Phone:*

Organization:*

School (if applicable):

Street Address:*

City:*

State:*

ZIP:*

Are you 18 or older?:*

Briefly describe your history with SFA/CIW. Why are you interested in attending the Encuentro? Maximum 5 sentences:*

How will you apply what you learn and the connections you make at the Encuentro to further the work of SFA/CIW?:*

Are there any specific topics that you would like to see addressed at the Encuentro?:

Time & space constraints will prevent us from including everything, but we will consider all suggestions.

Campus Food Service Provider (if applicable):*

Are you proficient in::
Spanish
Haitian Creole

Are you interested in helping with translation during the Encuentro?:
Yes

Diet:*

Food Allergies:

Are you comfortable with gender-neutral housing?:*

Optional: Do you identify as a woman, person of color, indigenous, working class, queer, and/or differently-abled?:

This is a drug- and alcohol-free event. Do you agree to adhere to this policy?:*

Registration is a $50-$150 sliding scale. Do you anticipate needing a scholarship?:*

A limited number of partial travel & registration scholarships are available for those who have exhausted fundraising options.

Would you like to receive a hard copy of the Encuentro binder for $10? (All participants will receive a free digital version.):*

Check out last year's binder contents here.

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