GGWash board application Question Title * 1. What is your name? (first & last) Question Title * 2. What is your email address? Question Title * 3. What is the ZIP code where you live? Question Title * 4. What is your gender identity? Male Female Gender non-conforming Prefer not to share Other (please specify) Question Title * 5. With which racial/ethnic heritage(s) do you identify? Please check all that apply. Black or African-American Hispanic or Latino American Indian or Alaskan Native East Asian South Asian Middle Eastern Caucasian or White Prefer not to share Other (please specify) Next