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Facilitating Civil Conversations- Online Thursday, December 14th, 10:00 AM-12:00 PM
Contact Details
Salutation
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Archbishop
Bishop
Chaplain
Dr.
Elder
Fr.
Imam
Lt. Colonel
Major
Mr.
Mrs.
Ms.
Msgr.
President
Pastor
Prof.
Rabbi
Rev.
Rev. Dr.
Sheik
Sr.
The Most Reverend
The Rev. Canon
The Rt. Rev.
The Very Reverend
Venerable
First Name
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CPA
D.D.S.
Esq.
II
III
IV
Jr.
M.D.
Ph.D.
Ret.
Sr.
Email
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Postal Code
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Afghanistan
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Bolivia
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Brazil
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Colombia
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Cook Islands
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Côte d ' Ivoire
Croatia ( Hrvatska )
Cuba
Cyprus
Czech Republic
Congo ( DRC )
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands ( Islas Malvinas )
Faroe Islands
Fiji Islands
Finland
France
French Guiana
French Polynesia
French Southern and Antarctic Lands
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
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Guatemala
Guinea
Guinea-Bissau
Guyana
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Heard Island and McDonald Islands
Honduras
Hong Kong SAR
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India
Indonesia
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Israel
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Liberia
Libya
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Lithuania
Luxembourg
Macao SAR
Macedonia, Former Yugoslav Republic of
Madagascar
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Malaysia
Maldives
Mali
Malta
Marshall Islands
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Mauritius
Mayotte
Mexico
Micronesia
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Monaco
Mongolia
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Morocco
Mozambique
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Namibia
Nauru
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Netherlands
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New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
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North Korea
Northern Mariana Islands
Norway
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Pakistan
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Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
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Romania
Russia
Rwanda
Samoa
San Marino
São Tomé and Prìncipe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
Spain
Sri Lanka
St. Helena
St. Kitts and Nevis
St. Lucia
St. Pierre and Miquelon
St. Vincent and the Grenadines
Sudan
Suriname
Svalbard and Jan Mayen
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
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Vanuatu
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Organization / Congregation / School
Title
Faith Tradition:
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Atheist
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Buddhist
Christian
Hindu
Jewish
Mormon
Muslim
Quaker
Secular
Sikh
Unitarian Universalist
None
Other
Other Faith Tradition (please specify):
Denomination:
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Catholic - Roman
Catholic - Ukrainian
Christian - Evangelical
Coptic Orthodox
Greek Orthodox
Jewish - Conservative
Jewish - Orthodox
Jewish - Reconstructing
Jewish - Reform
Jewish - Renewal
Latter-Day Saints
Mennonite
Muslim - Shia
Muslim - Sufi
Muslim - Sunni
Nation of Islam
Protestant - African Methodist Episcopal
Protestant - Baptist
Protestant - Episcopal
Protestant - Lutheran
Protestant - Presbyterian
Protestant - United Church of Christ
Protestant - United Methodist
Salvation Army
Other
Other Denomination (please specify):
Race/Ethnicity:
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African American
American Indian
Arab American
Asian
Black
Hispanic
White
Two or More Races
Other
Other Race/Ethnicity (please specify):
How did you hear about this training?
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Internet Search
Facebook/Social Media
Interfaith Philadelphia Email/Newsletter
Partner Email/Newsletter (ex: On Being, NCC, WHYY, etc.)
Referred by Friend/Colleague
Flyer/Poster
Attended Event/Met Interfaith Philadelphia Staff
Other (please specify in space below)
Other (please specify):
What is one thing you would be especially interested in learning at this training?
What type of difficult conversation are you seeking skills for through this training? Is there a specific topic that you or your community are interested in designing an event around?
Any additional comments for the organizers regarding special accommodations and/or dietary restrictions?
**Staff Members Only**
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I am a staff member
**Faith & Social Impact Program Participants Only**
Please check the box below to confirm:
I am a participant in the Penn/Interfaith Philadelphia Faith & Social Impact Program
Program Fees
Interfaith Philadelphia offers a sliding scale fee structure for our programs in order to welcome all from our community who wish to attend.
The
sliding scale
fee for each program is $15-300 with a
suggested price
of $100. For more information on how to determine the cost that is right for you,
click here
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