Registration Form - W+OCP 2024 Survey

1.What is your full name?(Required.)

First Name

Middle Name(s)

Last/Family Name(s)

Preferred Name or Nickname

2.What is your email?(Required.)

Main address

Confirm main address

Alternate address

4.With which racial/ethnic group(s) do you identify? (please select all that apply)(Required.)

Asian (including all people across the continent)

Black (including African-American, Black African, Afro-Caribbean, etc.)

Indigenous American or Native Alaskan (including all indigenous populations across the Americas)

Latine or Hispanic

Middle Eastern/Southwest Asian or North African

Mixed

Native Hawaiian or Pacific Islander

White

Other race/ethnicity OR if you would like to specify an aspect of your identity:

6.Are you an international student? (i.e. a student who is not a U.S. citizen or permanent resident)(Required.)

Yes

No

7.From which country will you be attending the sessions?(Required.)

8.If you are based in the U.S.: From which state or territory will you be attending the sessions?

9.What is your current or most recent university, institution, or workplace?

If you are currently based in a university, please find yours in the following dropdown.
If yours is not in the list OR you are currently based in a non-academic institution, please select "Other university OR I am currently based in a non-academic institution" (at the bottom of the dropdown list) and use the comment box that appears to tell us where you are based.(Required.)

10.Would you like to stay informed about future events or opportunities with W+OCP?(Required.)

Yes

No