Facilitator Collaboration Membership Renewal

Your Personal Information

Email*(Required)

Phone*(Required)

Demographic Information

While not required, we invite and encourage you to share any additional demographic information you would like to about how you identify. We strive to be inclusive of everyone so they can feel welcome and protected while disclosing their information. By collecting this information, we’re better to able to track the diversity of our global community and follow up with you about specific ways to engage with various resources and communities of practice. All fields are optional, and the information you choose to provide will not be shared beyond the CCR staff.

Gender: Self-Identify

Pronouns

Race and Ethnicity: Self-Identify

Sexual Orientation: Self-Identify

Spiritual and Religious Affiliation: Self-Identify

Spoken Languages

Please list below any languages that you speak fluently.

Please share any additional information about your identity.

Vocation or Profession

While not required, we invite you to provide this information to help us keep track of the professional backgrounds represented in the work that we do, as well as gain a better understanding of who is participating in the program. This information also helps us recommend specific interest groups, programs, resources, or learning communities that you might find helpful in the future. We welcome people of all vocations: those still seeking a vocation, those who have left behind a vocation, and those in transition.

Professional Role / Vocation

Employer

Sectors and Focus Areas

We invite you to check any of the options below based on your personal and/or professional experiences and interests. Again, this information helps us provide meaningful information for you about upcoming programs, resources, and points of connection. Please feel free to check any that you’re currently affiliated with or that deeply interest you.

Sectors and Focus Areas: Other

Any Additional Info

Is there anything else you'd like to share with us?

Please use the space below to provide any additional information you would like for us to know.

Payment Information

The recommended renewal fee for facilitators is $400. As always, we acknowledge that there may be a variety of financial or other considerations and have built that flexibility into the payment options below: 1) You can pay your full self-designated renewal fee online today, 2) You can set up a payment plan and make your first payment today, or 3) you can mail a check for your full renewal fee.

Please email Nichelle Harrison at nichelle@couragerenewal.org if you have any questions about your payment options or status.

What is the total amount you plan to pay for your annual renewal?*(Required)

The recommended renewal fee is $400, but you can also self-designate an amount based on your personal circumstances and considerations.

Please describe your preferred payment plan.*(Required)

What amount are you paying today?*(Required)

Enter amount to donate(Required)

Dedication or Specification To(Required)

Notify Someone of Your Dedication via Email (Optional)(Required)

If you would like to let this person or a member of their family know that you’ve dedicated this donation in their honor or memory, please provide the email address of the person below.

Memoriam Email Recipient Name(Required)

Please include the first name of the person whose email you listed above. We will contact them to inform them about your memoriam donation.

Renewal Fee – Full Payment

Price: $0.00

Renewal Fee – Partial Payment

Price: $0.00

Renewal Fee – Full Payment By Check

Price: $0.00

Donation(Required)

Price: $0.00

Donation(Required)

Price: $0.00

Transaction Fee

Price: $0.00

Total Payment

Please mail your check to:
Center for Courage & Renewal
2435 E. North Street, Suite 1108-111
Greenville, SC 29615
Please include “Facilitator Collaboration Membership Renewal” in memo line.

Credit Card(Required)

Card Details

Cardholder Name

Please make sure that you have reviewed the acknowledgements listed in the 2023/24 Mutual Support Agreement before submitting the form. Click here to review the MSA.

CAPTCHA

Search

Search

Renew Your Annual Facilitator Collaboration Membership

Your Personal Information

Demographic Information

Vocation or Profession

Sectors and Focus Areas

Any Additional Info

Payment Information