Please complete the following survey as part of your application to participate in a Community of Practice for the Community Engagement Professional Credentialing Program. More information on the credentialing program can be found at credential.compact.org.  

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* 1. First Name

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* 2. Last Name

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* 3. What gender pronouns do you use?

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* 4. Email address

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* 5. Phone (cell)

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* 6. Phone (work)

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* 7. Please indicate which Community of Practice (CoP) you wish to participate in. You may apply to participate in both; however, you will only be selected for one (answer will be first choice [ ] and second choice [ ]):


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* 8. Please briefly explain why you wish to participate in a CoP for the CEP Credentialing Program: 

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* 9. I have completed the self-assessment section of the Community Engagement Fundamentals micro-credential.  

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* 10. I have completed the self assessment section of the Community Partnership micro-credential. 

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* 11. I commit to participating in all virtual CoP meetings

0 of 11 answered
 

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