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* 1. Please provide your email address

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* 2. Which of the Blueprint Levers are you planning to work on? (check all that apply)

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* 3. Which goals in the Blueprint do you, your organization, and/or State work on that will support our collective impact goals?

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* 4. What would you add to ensure equity and inclusion in this work?

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* 5. Can you think of any individuals or organizations working in any of the lever areas that we should connect with? If yes, provide contact information.

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* 6. What resources or other information can you share that will help move the Blueprint work forward?

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* 7. What is the best method for OPEN to communicate with you? (e.g. OPEN Communities, SLACK, email, etc.)

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* 8. How can OPEN support you to actively engage in implementing the Blueprint activities within the Network and in your communities?

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* 9. Do you have any remaining questions or concerns?

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