Name
*
First Name
Last Name
Pronouns
*
Email
*
Best Contact Number
(###)
###
####
Please share how you heard about this event. If an organization or collective shared it with you, please offer their name.
Tell us about your experience with somatic practices and improvisation:
Tell us about your experience with anti-racism and social justice work:
Is there anything else you would like to share?
Please confirm that you can make all dates and times during the Retreat. If you are unable to attend the whole time, please share your schedule in the following section. We prioritize those who can make the whole time.
*
If you can't join for all the sessions, let us know more here:
Some food-sharing will take place at the retreat. Do you have any dietary restrictions or sensitivity?
Please share any other dietary needs here:
Do you have any access realities that we can do our best as a community to accomodate? (ie. physical like wheelchair accessibility, or social like hypersensitivities around police.) Please share here if you have allergies, or if you have any particular needs around lodging as well!
We are excited to offer this workshop to the AANHPI community! Please indicate your diaspora ethnicity(ies). If you have more than one ethnicity, please share additional information in the next question.
Afghanistan
Armenia
Artsakh
Azerbaijan
Bahrain
Bangledesh
Bhutan
Brunei
Burma
Cambodia
China
Cyprus
Georgia
Hong Kong
India
Indonesian
Iran
Iraq
Japan
Jordan
Kazakhstan
Kuwait
Kyrgyzstan
Laos
Lebanon
Malaysia
Maldives
Mongolia
Nepal
North Korea
Oman
Pakistan
Palestine
Philippines
Qatar
Saudi Arabia
Singapore
South Korea
Sri Lanka
Syria
Taiwan
Tajikistan
Thailand
Tibet
Timor-Leste
Turkey
Turkmenistan
United Arab Emirates
Uzbekistan
Vietnam
Xinjiang
Yemen
Other (Please specify below)
Please share your gender identification:
Female, femme, transfeminine
Male, masc, transmasculine
Non-binary, gender fluid, or non-conforming
Gender unknown, or prefer not to say
Other (Please specify below)
Please share anything else that you wish for us to know about your identity (age, ability, sexuality, income, etc):
Is there anything else you would like to tell us? (If you have not been exposed to Moving Rasa, this is an important space for you to share more about why this workshop is of interest to you and what your background experience is.)
