| Resume a previously saved form
Resume Later

In order to be able to resume this form later, please enter your email and choose a password.


Instructions


Please complete the following form. The process typically takes 15-20 minutes.

If you need to stop and resume at a later time, there is a checkbox (above) that enables you to save your progress. Required fields are marked with an asterisk (*). You will need to provide your email address and password each time you save your application. An email with a link to resume your application will be sent to the email you provide.

Once you complete the form, click "Next" to review your application. Afterwards, click "Confirm" to send us your application. You will receive an update on the status of your application in 10-12 business days.
Seminar Choice




Please select all that apply.

Affiliation/Fees
The training fee for this training is based on a modified sliding scale, weighted against your organization's budget or assets in the current year. Participants are expected to cover their travel costs.

To determine your training fee, please indicate the type of organization you work for and its budget or asset range. The fee that displays is an estimate for the program you are applying for; the actual fee will be listed in the invoice you receive upon acceptance.







$

$

$
Organization Contact Info

If you're not affiliated with an organization, please enter "Unaffiliated" above


If you do not have a website, please enter "N/A" above






Individual Contact Info

Please indicate your PREFERRED first name. The name you provide here will be displayed during the online session.



Please let us know what you'd like to be called during your training.

Please share your pronouns with us (i.e. she, he, they, etc.)

Please provide your name as you would like it to appear on your certificate of completion.























Organizational Information

Please select all that apply.


Please select all that apply.


Please select all that apply.


Please select all that apply.

Additional Information

Please select all that apply.


Please select all that apply.


Please select all that apply.

Lodging/Dietary Preferences
All of our trainings are shared occupancy. Rockwood typically arranges rooming based on the age and gender of participants. If you would like us to consider any particular preferences or needs when assigning rooms, please specify below.

Please select all that apply.
Emergency Contact Information
Please let us know who to contact in the event of an emergency. This information will remain confidential and will be used by Rockwood staff for notification purposes only in case of an emergency.

















Other Information
Training cohort selections are influenced by Rockwood’s commitment to race equity and creating a diverse learning community. The below information will help us build such a community. All information is kept strictly confidential.

Please select any/all choices with which you identify.


Please select any/all choices with which you identify.


Please select any/all choices with which you identify.



Please click "Next" to review your application. Afterwards, click "Confirm" to send us your application. You will receive an update on the status of your application in 10-12 business days.