Registration FormCrossing Borders Education is an international non-profit organization. We are so excited to welcome you to our dialogues!"*" indicates required fieldsFirst Name*"*" indicates required fieldsSurname*Email Contact* Institution*OccupationCountryAge 18-24 25-34 35+Gender Male Female Prefer to self describe Prefer not to sayGender: Prefer to self describe as (Please specify here)My English language skills are: Fluent Intermediate Native SpeakerDo you require learning accommodations? Yes NoPlease let us know your needs to support your learning experience:Please select the blocks of dates:* Block One: Nov 8, 10, and 12 (New York Time: 10am-noon EST) Block Two: Nov 14, 16 and 19 (New York Time: 10am-noon EST)(Numbers are limited. Please select all blocks that are possible for you to attend.)I understand that I am committing to join all three dates in my preferred block(s).* AgreedI commit to the values of CBE Dialogue Agreements.*(They are key for creating a nurturing space for building trust.) Agreed Click image to enlarge My main reason to participate is:How did you hear about our dialogues?(Please tick all that apply) Friend / Colleague The Outrage & Optimism podcast LinkedIn Twitter Cisco OtherHow did you hear about our dialogues: Other (Please specify here)
