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GC82 House of Deputies Legislative Committee Preference Survey
*
1.
Are you a Deputy or an Alternate Deputy?
(Required.)
Deputy
Alternate Deputy
Other
Other (please specify)
2.
What is your first name?
3.
What is your last name?
4.
Address
Address 1
Address 2
City/Town
State/Province
AL Alabama
AK Alaska
AS American Samoa
AZ Arizona
AR Arkansas
CA California
CO Colorado
CT Connecticut
DE Delaware
DC District of Columbia
FM Federated States of Micronesia
FL Florida
GA Georgia
GU Guam
HI Hawaii
ID Idaho
IL Illinois
IN Indiana
IA Iowa
KS Kansas
KY Kentucky
LA Louisiana
ME Maine
MH Marshall Islands
MD Maryland
MA Massachusetts
MI Michigan
MN Minnesota
MS Mississippi
MO Missouri
MT Montana
NE Nebraska
NV Nevada
NH New Hampshire
NJ New Jersey
NM New Mexico
NY New York
NC North Carolina
ND North Dakota
MP Northern Mariana Islands
OH Ohio
OK Oklahoma
OR Oregon
PW Palau
PA Pennsylvania
PR Puerto Rico
RI Rhode Island
SC South Carolina
SD South Dakota
TN Tennessee
TX Texas
UT Utah
VT Vermont
VI Virgin Islands
VA Virginia
WA Washington
WV West Virginia
WI Wisconsin
WY Wyoming
ZIP/Postal Code
Country
*
5.
Preferred email
(Required.)
6.
Confirm preferred email
7.
Telephone (cell phone preferred)
8.
Date of Birth
Month
Date
Year
9.
How would you identify your gender?
10.
Please, Identify your sexual orientation.
11.
What is your preferred language?
English
Spanish
French
Mandarin Chinese
Other (please list below)
If your preferred language is not listed, please share it here.
12.
In what languages are you fluent?
The business of The General Convention will be conducted in English with Spanish interpretation. If you require additional interpretation/translation services, please contact the General Convention Office at GCOffice@episcopalchurch.org.
13.
Will you need interpretation in order to participate in a legislative committee?
Yes
No
14.
Please select the description that best represents your racial and ethnic heritage.
Indigenous, Native American, or Alaskan Native
Hawaiian or Pacific Islander
Middle Eastern or Arab American
Black, African American, Afro Caribbean, African Immigrant, or African Decent
Asian or Asian American
Latino/a/x
White
Multiracial or Biracial
Not listed (please specify)
If you would like the opportunity, we invite you to describe your race/ethnicity below