To learn more about this year's Summit visit: https://withkeri.com/2022summit/

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1. Please Enter Your Contact Information
(Required.)

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2. Are you a current student, recent graduate or community organizer?

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3. What school do you attend? (if applicable)

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4. What company or organization do you represent?
(Required.)

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5. Pronouns

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6. Are you a part of the BIPOC (Black, Indigenous & Person of Color) Community?
(Required.)

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7. Are you a part of the Disability Community?
(Required.)

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8. Why would you like to attend the 2022 NAMD Advocates Leadership Summit?
(Required.)

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9. How would you describe your work or career aspirations? Does your work intersect with racial and disability justice?
(Required.)

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10. What does "Our Presence is Our Power" mean to you?

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