| Name of Person Filling Out This Form |
Mikele Rauch
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| E-Mail of Person Filling Out This Form |
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| Phone # of Person Filling Out This Form |
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| Name of Primary Point of Contact, if other than the person filling out this form: |
Chad Corbley. [email protected]
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| Organization Name |
TakingBackOurselves
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| Organization Address |
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| Proposed Event Address (if offsite from city facilities) |
ARC
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| Is your organization a nonprofit organization, a West Hollywood Neighborhood Watch Association, West Hollywood business or business the serves the West Hollywood community, or a governmental organization? |
Yes
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| Name of Proposed Co-Sponsorship Event |
Night of Healing
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| Anticipated Attendance |
100
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| Is this event free and open to the public? |
Yes
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| If not free and open to the public, please explain why. |
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| If this event is charging for entry, please list the price(s) to attend |
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| Please explain the purpose of this event and why it is important for the City to co-sponsor this event |
This free event is for survivors of sexual assault and trauma--for all genders, and those who support them: organizations, resurces, professionals, family and friends of survivors, caregivers, law enforcement and interested parties: survivors of incest, sexual assault, sexual trafficking, campus rape, domestic violence, religious abuse, military sexual assault, war crimes, tribal and racial violence,
If you have been trafficked as a child, adolescent, or adult--
or as a sex worker
For survivors of sexual assault in the workplace by a man OR a woman; f as a child , continually exposed to sexual violence or graphic pornography, if confused about what one did or were coerced to do in family, church, neighborhood or school
If a male survivor
If a woman who is a survivor
If a trans survivor
If one is a partner, a friend, a relative, a caregiver for someone who has experienced sexual violation
mental health professionals, physicians, OB GYN, EMS, chiropractors, providers of Reiki, cranial sacral work, acupuncture, yoga instructors, body workers, men’s resource , LGBTQ providers, police, military victim advocates:
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| How does this event benefit the West Hollywood community and/or the City? |
West Hollywood, which is truly a sanctuary city for LGBTQI, would deeply benefit from an event specifically dedicated to this subject where individuals and supporters can come together, and experience a gathering where information and inspiration and resources are given.
We envision tables for organizations and resources, an art exhibit with local and survivor artists, a musical performance, a panel of speakers from the TBO and MenHealing Community to talk about the gifts and challenges of recovery, and a facilitated open discussion for questions and sharing
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| Please list the names of all event participants (panelists, presenters, performers, speakers, lecturers, etc.) for each/all day(s) of the event: |
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| Please provide a summary of examples of a previous event(s) and/or programming produced by your organization that demonstrates the organization’s capability to deliver high-quality events and/or programming similar to the one you are proposing in this application |
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| Has your organization received a City of West Hollywood co-sponsorship before? If so, for what event (name & date of event)? |
We were scheduled to hold an Event of Healing with the City of West Hollywood in 2020 but had to cancel a month out because of the pandemic.
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| Is this event held on one date, or multiple dates? |
One Date
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| What does your event request in City support: |
City Facility Use (if yes, which facility and room, as applicable), Promotion of the event via the City’s communication channels, Validated parking at a City Lot (if yes, which City parking lot or parking facility), Monetary Support. Not all Co-Sponsorships will include monetary support from the City. Please keep in mind, public funds must be used to support the community, must serve a public purpose, and requests will be reviewed in accordance with all applicable laws. The request must explain how this funding would be used to cover direct program costs. Funds are disbursed on a reimbursable basis after the provision of suitable expenditure documentation (e.g., receipts).
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| If requesting monetary support, please list an estimated amount: |
$100.00
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| If requesting facility use, please list the name & location of the facility requested: |
ARC
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