* 1. First and Last Name

* 2. Which location is best for you?

* 3. Your brief bio? [where you are from, degree major, professional experience. Our jury board is an intimate group, please share whatever describes you the best]

* 4. Approximate Age

* 5. Why would you like to join the Jury Board? 

* 6. Email address to contact you

* 7. Best phone number for a quick introduction?