DEI Membership Grant Application

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* 1. Name:

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* 2. Email Address:

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* 3. Age:

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* 4. Race:

White

Hispanic or Latino

Black or African American

Native American or American Indian

Asian/Pacific Islander

Other (please specify)

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* 5. Gender:

Male

Female

Non-binary

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* 6. Education level:

High school graduate

Some college, credit

Associate degree

Bachelor's degree

Master's degree

Professional degree

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* 7. Employment status:

Employed full-time

Employed part-time

Self-Employed

Student

DEI Membership Grant Application

Question Title

* 1. Name:

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* 2. Email Address:

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* 3. Age:

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* 4. Race:

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* 5. Gender:

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* 6. Education level:

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* 7. Employment status:

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* 8. Why are you most deserving of this grant? (500 character limit)

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* 9. What are your long-term career goals? (500 character limit)

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* 10. What has been your proudest accomplishment in your career thus far? (500 character limit)

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* 11. What are you hoping to gain from joining the PRSA Hoosier chapter? (500 character limit)