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* 1. Who will be in your off-site group?

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* 2. What kind of site will you be participating from?

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* 3. I understand that the live event will be January 30th from 11:30 pm -1 pm & that off site locations will be responsible for how they plan &  communicate about lunch arrangements with their participants.

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* 4. How do you prefer to be communicated with about this upcoming event?  Check all that apply. 

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* 5. Will you be participating from home or phone as an individual?

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* 6. Your privacy will be preserved.  The information you provide will only be used as needed to assist in the success of this cutting edge event.

It is also part of how our grant data will be reported but WITHOUT any specific names, emails, or phone numbers attached to the data. 

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