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* 1. Your First and Last Name

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* 2. Your preferred email

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* 3. How have you been involved with AAIW in the past?

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* 4. Going forward, we will have regional teams.  Which of the following would work best for you.

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* 5. What meeting times for the regional team would work best for you?

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* 6. For those with little time but a willingness to advocate for AAIW, we are creating the Ambassador Circle.  Would you like to learn more about becoming an ambassador?

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* 7. We are looking to create an update line-up of Action Teams.  Which of the following would be of interest to you.

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* 8. We will be building a powerful knowledge  inventory to help educate audiences and individuals in the State.  How would you like to be involved? 

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* 9. Being a part of the AAIW community will be free (to promote learning from each other and networking).  But we are creating a premium level (individual supporter) which allows for access to the community directory, the full knowledge inventory (for personal learning), and provides 50% discounts to AAIW events.  What do you believe an adequate value would be?

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* 10. I can offer expertise with the following disruptive technologies

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