ACE Interface ACEs Learning Session Section 1 Question Title * 1. What date was your ACEs learning session? Date Date OK Question Title * 2. Name of Presenter Amy Witt Billie Jo Bakeburg Cassie Nagel Chelsie Ogaard Heather Tromp Jessica Broullire Karly Winter Kehala Two Bulls Mary Beth Holzwarth Mary Kurniawan Mary Merrigan Melita Rank Rachel Shepherd Shana Cerny Shelly Fuller Staci Born Staci Jonson Suzanne England Tanya Fritz Teresa Thie Teri Beeson Terry Liggins Tifanie Petro Tracey Palecek Other (please specify) OK Question Title * 3. Additional Presenter? Amy Witt Billie Jo Bakerberg Cassie Nagel Chelsie Ogaard Heather Tromp Karly Winter Kehala Two Bulls Mary Beth Holzwarth Mary Merrigan Melita Rank Rachel Shepherd Shana Cerny Shelly Fuller Staci Born Staci Jonson Suzanne England Tanya Fritz Teresa Thie Terry Liggins Tifanie Petro Tracey Palecek Other (please specify) OK Question Title * 4. Additional Presenter? Amy Witt Billie Jo Bakerberg Cassie Nagel Chelsie Ogaard Heather Tromp Karly Winter Kehala Two Bulls Mary Beth Holzwarth Mary Merrigan Melita Rank Rachel Shepherd Shana Cerny Shelly Fuller Staci Born Staci Jonson Suzanne England Tanya Fritz Teresa Thie Terry Liggins Tifanie Petro Tracey Palecek Other (please specify) OK Question Title * 5. Your age Under 20 years 21-30 years 31-40 years 41-50 years 51-60 years 61+ years Prefer not to say OK Question Title * 6. Your race/ethnicity African American Asian American/Pacific Islander Caucasian Hispanic/Latino(a) Native American Indian Other Prefer not to say Other Other (please specify) OK Question Title * 7. Sectors you most closely identify with: Business Child Care Civic Community Initiatives Education 12+ Emergency Responders Faith-Based Funders Health Justice System Media Political Organizations Recreational Clubs and Organizations Social Services Youth Organizations Education Student Other (please specify) OK Question Title * 8. Select all counties in which you reside, work, and where the ACEs learning session was located. Aurora Beadle Bennette Brookings Brown Brule Bon Homme Buffalo Butte Campbell Charles Mix Clark Clay Custer Codington Corson Davison Day Deuel Dewey Douglas Edmunds Fall River Faulk Grant Gregory Haakon Hamlin Hand Hanson Harding Hughes Hutchison Hyde Jackson Jerauld Jones Kingsbury Lake Lawrence Lincoln Lyman Marshall McCook McPherson Meade Mellette Minnehaha Minor Moody Oglala Pennington Perkins Potter Sanborn Roberts Shannon Spink Stanley Sully Todd Tripp Turner Tripp Union Walworth Washabaugh Yankton Ziebach OK Question Title * 9. List the tribal region in which you reside, work, or where the learning session was held. (If applicable) Cheyenne River Sioux Tribe Crow Creek Sioux Tribe Flandreau Santee Sioux Tribe Lower Brule Sioux Tribe Oglala Sioux Tribe Rosebud Sioux Tribe Sisseton Wahpeton Oyate Standing Rock Sioux Tribe Yankton Sioux Tribe OK NEXT