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Email*First name*Last name*Phone number (if we can't reach you by email)*Your organization (if you are an internal consultant)Please explain your interest in joining a Coaching for Social Justice coaching supervision groupWhat is your experience with DEIJB? (These groups are currently not designed for people who are completely new to DEIJB)
What is your experience with coaching (or your profession, if not coaching)
We are currently offering mixed groups. If you would prefer a specific affinity group (e.g., People of Color, White) please let us know what sort of group you would prefer and to what degree that would impact your decision to join a group

Equity pricing
No needYes - but will pay full price if not currently availableYes - but add me to waitlist if not currently availableYes - but only interested now if currently availableOther

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