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General Information & Self-Identification

The leadership track of the Black Boardroom Leadership Institute (BBLI) is intended for Black leaders who live in the Orlando 4-county region.

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* 1. Contact Information

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* 2. Employment

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* 3. Is your current employer private or public?

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* 4. What is your racial or ethnic identity? (Select all that apply.)

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* 5. Polo Shirt Size

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* 6. What is your age?

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* 7. What is your gender identity?

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* 8. What is your sexual orientation?

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* 9. Do you identify with any of the following religions? (Select all that apply.)

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* 10. Are you a person living with a disability?

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