Antiracism Discipleship Pathway

To register for an Antiracism Discipleship Pathway (ADP), please provide the following information. Your answers will help us create ADP cohorts.

Name*

Email*

Phone Number*

Conference*

Name of your Congregation*

City/Town you serve in:*

State, province, or part of the world you serve in:*

What time zone are you in?*

Ministry Title*

Ministry Context*

Age range*

How do you racially or ethnically identify yourself?*

I would consider myself…*

Share your experiences...

Please check all the Covenant immersive discipleship experiences and resources you have participated in or used.*

Sankofa
J2M (Northwest Conference)
J2M (Midwest Conference)
Immigration Immersion
Weaving Justice and Peace in a Wounded Land
Invitation to Racial Righteousness
Justice Journey for Kids
Life Together Bible Study Series
Taken a course at Statesville through the SRA program
Unite Pre-CHIC curriculum
SEC Immersion Journey (Southeast Conference)
None of the above.

Have you completed the Intercultural Development Inventory (IDI) assessment in the last two years?*

Yes
No

Have you read any of the following books?

Rediscipling the White Church: From Cheap Diversity to True Solidarity by David W. Swanson*

Yes
No

The Color of Compromise: The Truth About the American Church’s Complicity in Racism by Jemar Tisby*

Yes
No

Subversive Witness: Scripture's Call to Leverage Privilege by Dominique DuBois Gilliard*

Yes
No

What is the last book you read or film you watch about racial justice and/or reconciliation?*

What days of the week work best for you to virtually meet? Please check all that apply!

Mornings

Monday morning
Tuesdaymorning
Wednesday morning
Thursday morning
Friday morning
Saturday morning

Afternoons

Monday afternoon
Tuesday afternoon
Wednesday afternoon
Thursday afternoon
Friday afternoon
Saturday afternoon

Evenings

Monday evening
Tuesday evening
Wednesday evening
Thursday evening
Friday evening
Saturday evening
Sunday evening

Registration

Which pathway are your registering for?*

Cost:*

Registration Fee ($150.00)
Choose your payment option below:

Running Total

$150.00

Total

$150.00

Coupon Code

Billing Information

Name*

Credit Card*

Visa
Mastercard
American Express
Discover

Address*

Email*

RegFox Event Registration Software

Event Registration Software by RegFox