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.

* 1. Your Name

* 2. Your email

* 3. Do you belong to a faith community?

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

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

* 6. Are you an elected official?

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

* 8. Do you own a small business?

* 9. Do you do volunteer/service work?

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