Tools For Tolerance® For Educators Registration
(California Schools Pre-K - 12)

* required information

Please Provide Your Contact Information
We will begin to plan your Tools for Tolerance program(s) after this form has been completed. Your information will be confidential and used to help us design the program for your school/organization.
First Name:*
Last Name:*
Address Line 1:*
Address Line 2:
ZIP/Postal Code:*
Cell Phone:*
Business Phone:*
Alternate Contact Person:*
Alternate Contact Email:*
Alternate Contact Cell Phone:*
How did you learn about this opportunity?:*
Interested in:* a one-day program
a two-day program
Preferred Date(s) 1:*
Preferred Date(s) 2:*
Preferred Date(s) 3:*
If you are located outside a 50-mile radius from the MOT, are you/your school/district able to cover the cost of transportation?:* Yes
N/A (under 50-mile radius)
What method of transportation will require the grant help cover?:* Airfare
Ground transportation
If you are located outside a 50-mile radius from the MOT, are you/your school/district able to cover the cost of flying?:* Yes
N/A (under 50-mile radius)
If flying, please identify a major airport closest to you.:
If you are located outside a 50-mile radius from the MOT, are you/your school/district able to cover the cost of accommodations:* Yes
N/A (under 50-mile radius)
Total # of Participants (minimum 30 people):*
Please describe your participating group (racial, ethnic, gender, socio-economic status, ages, religions, etc.):*
What is the composition of your group (mostly either classroom teachers, administrators, classified staff, a mixed group, etc.)?:*
Describe any on-going/previous professional development training related to campus climate, diversity, social justice, etc.):*
Please indicate the provider(s) of the aforementioned professional development training (if applicable):*
How does this professional development program fit into larger plans and strategic goals of your educator team?:*
What do you see as some of the challenges facing your school community that could be addressed in this program?:*
Simon Wiesenthal Center Updates: Yes

Program Goals
This program includes exploration of Museum exhibits, facilitated dialogue and discussion, special speakers and customized workshops. Please choose the content area you would most like to explore further and select the focus for your workshop:
CHOOSE:* A. Creating a positive and inclusive school climate: Best suited for educator teams; including teachers, classified staff, administrators, counselors, etc. This program could include content on cultural proficiency; addressing equity, bullying prevention, restorative justice, hate and bias; leadership development, etc.
B. Curriculum Transformation through a Social Justice Lens: Best suited for classroom teachers this program could focus on Common Core, teaching the history of the Holocaust, thematic model lessons, service learning, media literacy, etc.
Please explain your choice & goals:*

PLEASE NOTE: Once you press the submit button, you will be taken to an automatic confirmation page. Please do not close your browser prior to this confirmation appearing, as it will cancel your submission.

This is only a confirmation that your registration has been submitted, not a confirmation of your program.

We will send you confirmation materials upon review of your registration. If you do not hear from us please contact to confirm that your information was received.

We recommend printing or saving the contents of this form for your records, in case of submission processing error.


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