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Jacksonville Human Rights Commission
Study Circles Initiative - Registration Form

(* Required fields)

Name*:

Home Phone*:

Cell Phone:

Office Phone: Ext.

E-mail*:

Mailing Address*:

City*: State*: Zip*:

Gender*: Male Female

Race/Ethnicity*:

If Other (specify):

As a participant with a circle study group, you are asked to make a good-faith effort to attend all meetings. If you are unable to attent the first sessions, you will be re-assigned to another group.

If you know of a specific study circle you would like to attend, enter its number here:

HOW DID YOU LEARN OF THE STUDY CIRCLES INITIATIVE?

Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing. - - - - - - -
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Jacksonville Human Rights Commission Study Circles Initiative - Registration Form
	(* Required fields)
Name*:
Home Phone*:
Cell Phone:
Office Phone:	Ext.
E-mail*:
Mailing Address*:
City*:	State: Zip:
Gender*:	Male Female
Race/Ethnicity*:
If Other (specify):

As a participant with a circle study group, you are asked to make a good-faith effort to attend all meetings. If you are unable to attent the first sessions, you will be re-assigned to another group.
If you know of a specific study circle you would like to attend, enter its number here:
HOW DID YOU LEARN OF THE STUDY CIRCLES INITIATIVE?