KBC 2022 Breastfeeding Conference

October 13-14, 2022
Holiday Inn East, Wichita

Question Title

* 1. First Name (as it appears on your license if applicable)

Question Title

* 2. Last Name (as it appears on your license if applicable)

Question Title

* 3. Email

Question Title

* 4. I am registering for:

You will pay at the end of this survey.

Question Title

* 5. Nursing License # (if applicable, for RNs, APRNs, LPNs)

Question Title

* 6. Kansas Dietitian License Number # (if applicable)

Question Title

* 7. Name of your organization/employer (if applicable)

Question Title

* 8. Name on credit card if different than the person registered.

Question Title

* 9. Are you a WIC staff member/employee?

Question Title

* 10. County

Question Title

* 11. In which geographic region of Kansas do you reside?

Question Title

* 12. Age

Question Title

* 13. Race and ethnicity (check all that apply)

Question Title

* 14. Which of the following best describes your current occupation/place of employment?

Question Title

* 15. Do you belong to a local or regional breastfeeding coalition in Kansas?

Question Title

* 16. How many times have you attended the KBC’s annual Breastfeeding Conference?

T