Resilience Building Workshop Registration Form

This workshop is aimed at Black Asian Minority Ethnic people living or working in Lewisham

We can no longer afford to let it go or hold it in. Learning how to respond to discrimination, harassment and bullying is essential to our mental and physical health. We are please you will be joining us.

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* 1. First and last name

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* 2. Email Address

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* 3. Contact Number

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* 4. Which race/ethnicity best describes you? (Please choose only one.)

Black African

Black Caribbean

Asian

Mixed race

Another race or ethnicity (please specify)

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* 5. What is your gender

Female

Male

Non Binary

Prefer not to say

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* 6. Do you live in Lewisham

Yes

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* 7. Do you work in Lewisham

Yes

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* 8. Where do you work

NHS

Mind

Lewisham Council

SLaM

Lewisham Local

Other (please specify)

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* 9. Tell us about a specific work situation you would like support with e.g. your line manager, making a formal complaint, being silenced?

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* 10. How did you hear about the workshop

Mabadiliko

Friend or family member

Lewisham BME Network

Mind

SLaM

Lewisham Council

NHS

Lewisham Local

Staff Network

Other (please specify)

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* 11. I would like to receive email updates from Mabadiliko CIC about upcoming events and information.

Yes