Registration

Basic Information

First Name: Last Name: Email: Phone: Address: City: State: Zip: -

Work/Employment Information

Company: Title: Birth Date(MM/DD/YYYY): / /

Demographic Information

To be as inclusive as possible, we hope to collect data that will let us understand our members through a diversity, equity, and inclusion lens. The information you provide will help us tailor programming to you and allow us to see who we may be missing.

Gender 2

Female

Male

LGBTQIA

Prefer not to answer

Race/Ethnicity

American Indian or Alaska Native

Asian

Black or African American

Hispanic or Latino

Native Hawaiian or Other Pacific Islander

White

Prefer not to answer

Other or more than one race

Ethnicity

Hispanic or Latino or Spanish Origin

Not Hispanic or Latino or Spanish Origin

Prefer not to answer

Age Group

Under 18

18-24 years

25-34 years

35-44 years

45-54 years

55-70 years

Above 70 years

Prefer not to answer

Education Level

Some high school

High school degree or equivalency

Some college or community college

Associate degree

Bachelor's degree

Master's degree

Doctorate degree (ex. PhD, EdD, or Professional Degree)

Prefer not to answer

Event Interest

Passion Projects

Teacher Topics

Green Futures

Shifting Perspectives

Lunch & Learn

Health & Wellness

T-Shirt Size