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First Name *

Last Name *

Email *

Username *

Password *

Confirm Password *

Preferred Name

Gender *

Which pronouns do you prefer? https://pronouns.org/what-and-why *

Mobile phone *

City *

State *

Zip Code *

Country *

About me

Organization/Affiliation

Title/Role

Partner Status *

Do you identify as BIPOC? (Black, Indigenous, or a person of color) *

What lived and/or organizing experience, skills, or interests are you bringing to the Program?  *

List your advocacy/socially engaged work or interest area. *

How do you intend to implement the information gained from the Certification Program in your work or community? *

Additional Information to Consider *

Current Community Organizer/Advocate *

Aspiring Community Organizer/Advocate *

Do you live or work in a frontline community? (Frontline communities are those disproportionately impacted by systemic injustice.) *

Are you working in support of frontline communities? (e.g., offering technical assistance or other types of assistance.) *

Please select the courses you’re interested in enrolling in: (Select all that apply) *

Do you require any specific accommodations to access the course content? (Select all that apply) *

Do you have reliable access to the following? (Select all that apply) *

Would you like to join the BIPOC in ECJ directory? www.bipocinecj.org *

How did you hear about the TCLP Certification Program? *

Please add any comments or feedback below. *

Date of Application *

Please check to acknowledge the following: *

Disclaimer for Application: We ask about race and identity to help us understand who we’re reaching and to ensure we build an inclusive and representative program. However, this information is not used to determine eligibility or acceptance. Your responses to demographic questions will not affect your application status.

Please note that additional materials will be regularly added and updated to enhance the courses.

By signing up for TCLP's Black Liberation & Just Transition Certification Program, you are opting in to receiving TCLP emails from info@thechisholmlegacyproject.org. If you wish to opt out from receiving emails from TCLP, please change your preferences by clicking the "unsubscribe" button at the bottom of the email.

I am committed to active participation in the Program and will seek necessary support to allow me to engage with the curriculum (approximately 15 hours per program).

I accept the terms*

Complete the application below to apply for the Black Liberation and Just Transition Institute. Applications submitted by the 15th will receive a decision by the 1st of the following month.

Black Liberation and Just Transition Institute Application