Equity Advisory Panel Registration

SENA Neighborhoods 2020

Thank you for your interest in participating on one of our advisory panels. Please complete this form in its entirety. Questions should be directed to office@standish-ericsson.org. A participation confirmation will be sent to you via email.

Question Title

* 1. What is your contact information?

Name

Address

Email Address

Phone Number

Question Title

* 2. Do you rent or own your home?

Renter

Homeowner

Question Title

* 3. What is your ethnicity?

White or Caucasian

Black or African American

Hispanic or Latino

Asian or Asian American

American Indian or Alaska Native

Native Hawaiian or other Pacific Islander

Another race

Question Title

* 4. What is your age?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

Question Title

* 5. How long have you lived in Standish-Ericsson?

New resident

1-5 Years

6-10 Years

More than 10 years

Question Title

* 6. Are you able to participate via Zoom or another online platform?

Yes

Question Title

* 7. Are you available to participate in person with proper precautions?

Yes

Question Title

* 8. Rate your familiarity with SENA?

I am unfamiliar

I know you exist, but not what you do

I'm somewhat familiar and have attended SENA sponsored event(s)

I'm quite familiar and follow SENA on social media

I am very familiar with SENA through the website, social media, events and/or programs

I am unfamiliar

I know you exist, but not what you do

I'm somewhat familiar and have attended SENA sponsored event(s)

I'm quite familiar and follow SENA on social media

I am very familiar with SENA through the website, social media, events and/or programs

Thank you for taking the time to complete our registration form. We will be in touch soon with more information. Participants will receive a $100 stipend for their time. Stipends will be paid out after the 2nd meeting of the session is complete. Please direct any questions or concerns to office@standish-ericsson.org.