Ntosake, September 2022 – Gamaliel Network

Prefix

Name(Required)

First Last

Pronouns

Email(Required)

Phone(Required)

Gamaliel Affiliate(Required)

Track selection

First Level Cohort – First time to Ntosake or “I am being called upon to move beyond ‘worker bee’ to a group leader, and I need this time to reflect upon and declare my path to power.”

Second Level Cohort – Participated in Ntosake and Weeklong (both are required). I am a team leader (core team, task force, fundraising etc.) in my organization. I am fearless and determined but find myself asking for permission.

The “Formerly Incarcerated” Cohort– this track is tentative and requires registration of at least 15 formerly incarcerated women.

Ntosake para hispanohablantes monolingües: esta pista es tentativa y requiere el registro de al menos 15 mujeres hispanohablantes monolingües

Ntosake cohort track (select one)(Required)

First Level Cohort

Second Level Cohort

The “Formerly Incarcerated” Cohort

Ntosake para hispanohablantes monolingües

Ntosake Trainer or Staff (used by training staff only)

Lodging and travel information

Emergency Contact Name(Required)

First Last

Emergency Contact Phone(Required)

Emergency Contact Email(Required)

Preferred Roommate(Required)

Dietary Restrictions(Required)

Travel Plans(Required)

Payment

Rooming selection, includes training fee (affiliate)(Required)

$395 for Double Occupancy

$495 for Single Occupancy

Payment Options(Required)

Pay Now

Pay Later

Total

Billing Address(Required)

Street Address City State ZIP Code

Credit Card(Required)

Card Details

Cardholder Name