Live Like a Citizen Interest Form ⋆ Citizen University

Company

This field is for validation purposes and should be left unchanged.

First Name*

Last Name*

Email*

Please share the email address that’ll be best for active communication with CU.

Address*

City State ZIP

Which of these best describes you?*

I work for an organization that’s interested in hosting LLAC for our community

I’m a volunteer or informal leader with an organization or group that may be interested in bringing LLAC to our community

I’m actively engaged in community life, and interested in LLAC as a participant

Other

Let us know if you’re reaching out about hosting, or participating in LLAC!

Are you connected with any local organizations who may be interested in hosting?

If so, share their names with us (and contact info, if you have it!), and share the Live Like a Citizen homepage with them. We need a host partner to bring this to your community!

Organization/Affiliation*

Organization/Affiliation Type*

Which of the following best reflects your organization/affiliation?

Describe your role*

Describe the civic practitioners you plan on gathering, and how you envision this training will benefit them*

How would you envision the makeup of this group?*

We lead LLAC with groups of 30-50. This could be a Private group; a Co-hosted group; or an Open group.

Private; people from within our organization/network

Co-hosted; people invited both from our organization, and amongst a few different community organizations that we could help identify

Open; people that we’d seek to recruit widely from the broader community

What timeframe would be ideal for bringing LLAC to your community?*

Check all that apply. As we connect directly, we’ll explore what’s specifically feasible together.

Winter 2027: January – March

Spring 2027: April – June

Summer 2027: July – September

Fall 2027: October – December

Sometime after

Give us some insight into the level of interest among your organization or group*

We are raring to go; aligned internally and eager to make this happen!

We are very intrigued and want to talk through details and questions

I would need to gain buy-in with other organizational decision makers

I’m interested, but need some more time—check back with me in a few months

Give us a sense of your hosting abilities!*

I feel confident in my organization’s ability to meet the hosting obligations

I would need to collaborate with other local groups or organizations to make this work

Other

As a reminder, host partners are responsible for: recruiting a full group, securing a venue, and providing meals during the training. For more details, refer back to the LLAC program homepage.

Anything else helpful to know about you or your group, or your community itself?

How did you hear about Live Like a Citizen?*

Web search/researching programs like this

Perusing Citizen University website

Citizen University newsletter

Citizen University staff member

From an event or media appearance with Eric Liu

An alum of a CU program

Recommended by another organization

Social media

Other

Share their name!*

Other*

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