80205 Summit Registration + Survey

1. 80205 Summit Registration

Thanks for signing up for the 80205 Summit on August 5th at Manual High School!

The first page covers important registration details, make sure you hit "Submit!"

On the following pages, we ask questions about the way all of us are connected and interconnected to each other so we can display this information creatively at the Summit! In order to do that, we need to know a little about you and how you experience the 80205 community. If you sign up but can’t make it, don’t worry – we will keep you connected with the area of work you designate below.

Please take a few minutes (5-10), right now, and sign up for the Summit and we hope to see you there.

If you have questions about this survey, please contact us at earlychildhood@civiccanopy.org or 303-292-3144 extension 217.

See you soon!

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* 1. Name:

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* 2. Organization/Network (if representing)

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* 3. My main Role for 80205 :

Community Member/resident

Local Business

Health Care/Public Health

Local Business

Educator/Teacher

Local Nonprofit

Other (please specify)

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* 4. Connection to 80205

I live in 80205

I used to live in 80205

I work in 80205

I used to work in 80205

I have family/friends in 80205

Other (please specify)

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* 5. Please check if you need any of the following (if you have specific needs, please specify in text box):

Childcare

Interpretation/Translation

Childcare

Dietary Restriction

Other

Please specify what you need:

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* 1. Name:

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* 2. Organization/Network (if representing)

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* 3. My main Role for 80205 :

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* 4. Connection to 80205

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* 5. Please check if you need any of the following (if you have specific needs, please specify in text box):

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* 6. Email (we will only use this to send you information about 80205 and the network)