HPD Training Working Group Interest Form

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* 1. What's your name?

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* 2. What e-mail address should we use to contact you?

This working group is intended to be primarily composed of young adult community members of color. Providing the demographic information below is optional but will help us learn if community interest is aligned with the project's purpose.

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* 3. How old are you?

Under 18

18-24

25-34

35-44

45-54

55-64

65+

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* 4. Which best describes you?

Black or African-American

Hispanic or Latino/a/e

White or Caucasian

Asian or Pacific Islander

Middle Eastern

Native American or Alaskan Native

Afghan

Other (please specify)

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* 5. What is your gender?

Female

Male

Non-binary

Other (please specify)