March Attendees: please let us know a bit about your other affiliations to help us understand what communities you belong to and what communities you might reach out to in order to share the value of science.

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* 1. Your Name

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* 2. Your email

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* 3. Do you belong to a faith community?

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* 4. Are you or have you served in the military or Coast Guard?

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* 5. Do you engage in any of the following activities? Please check all that apply:

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* 6. Are you an elected official?

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* 7. Are you involved in a PTA (parent-teacher association)?

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* 8. Do you own a small business?

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* 9. Do you do volunteer/service work?

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* 10. Are you involved in any other community service/organizing efforts?

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