Just Act Institute 2019 Registration Form

Hi! You have successfully reached the Just Act Institute for Theatre of the Oppressed Training registration form! Thank you for taking the time to complete it. Your responses will truly help us shape the workshop to your needs and interests in relation to the group.

I'm registering for the following workshop/s:

	you must have at least one item
16th Annual Forum Theatre Intensive, June 26-30	you must have at least one item
Advanced Joker Training 1, July 19-21	you must have at least one item
Advanced Joker Training 2, August 2-4	you must have at least one item

Name *

Last Name *

Preferred Name/ NickName

Pronouns *

Email Address *

Address *

City *

State *

Zip *

Phone *

Organization/Organizational Affiliation (if applicable)

Tell us a little about other aspects that describe you that you'd like to share to help us get to know you (racial & ethnic identity, class background, etc.)

How did you learn about this Just Act workshop? (be as specific as you can to help us learn how word gets out: friend recommendation, internet, attended a previous Theatre of the Oppressed workshop or Jam on Justice, etc) *

What are you passionate about in your work and life? Let us know how and where you are currently putting your energy and focus. *

What questions are you asking now? about yourself, your community, the world around you, yourself in relation to the world? *

Do you have any previous experience you have with Theatre of the Oppressed (where, with whom, etc). How have you utilized this knowledge? *

Please share why you want to participate in the Just Act Institute, either the Forum Theatre Intensive or Advanced Joker Training Classes? How will it be valuable for you at this moment? *

Please describe any forms of teaching, facilitation, training that you may lead (if applicable). TO or otherwise. *

If applying for either of the Advanced Joker Trainings, what questions are you grappling with as Joker? And, what do you seek to explore in these trainings?

Registration Fees: You can pay either a Deposit now with the balance of $425 due one month before the training, or pay the Full amount now. *

16th Annual Forum Theatre Intensive DEPOSIT ($50.00)	16th Annual Forum Theatre Intensive FULL ($475.00)
Advanced Joker Training 1 DEPOSIT ($50.00)	Advanced Joker Training 1 FULL ($285.00)
Advanced Joker Training 2 DEPOSIT ($50.00)	Advanced Joker Training 2 FULL ($285.00)
Special discount for both Joker Trainings ($520)	Additional Donation to help make a workshop accessible to those with less financial resources ($100.00)
Additional Donation to help make a workshop accessible to those with less financial resources ($50.00)

Current Total:

$0.00

Any questions, comments, concerns to better help us support you during the workshop?

Since we offer beverages throughout the training, which do you prefer so we can best provide for you?

	you must have at least one item
Coffee	you must have at least one item
Decaf Coffee	you must have at least one item
Herbal Tea	you must have at least one item
Caffeinated Tea	you must have at least one item
Cream/milk	you must have at least one item
Juice	you must have at least one item

We will be sharing breakfast foods and healthy snacks during the day. Do you have any dietary needs about which we should know?

Please click the "Continue" button, and it will take you to the payment page.

We will contact you by email within a week of your submission.

If you have any questions or want to reach out to us directly, please email us at info@justact.org

Thank you for registering for the Just Act Institute.