*1.Last Name(Required.)

*2.First Name(Required.)

*3.Do you plan to attend the workshop in person OR virtually?(Required.)

I will attend in person at Inspiredu's Volunteer & Training Center located at 1550 Southland Circle NW, Suite 200, in Atlanta. I understand that I will need to bring my laptop with me in order to participate in the learning session.

I will attend virtually using a Teams link. I understand that the link will be emailed to me by an Inspiredu staff member.

*4.Email Address(Required.)

5.Phone Number

*6.What YEAR were you born?(Required.)

*7.What is your Gender ?(Required.)

Female

Male

Non-Binary

Other (not listed above)

Prefer not to answer

*8.What is your Ethnicity/Race ?(Required.)

American Indian or Alaskan Native

Asian

Black or African American

Hispanic or Latinx

Native Hawaiian or Other Pacific Islander

White

Multi-Racial

Prefer not to answer

Other than listed above (please specify)

*9.What county do you live in? (example: Cobb, DeKalb, Fulton, Gwinnett, etc)(Required.)

*10.What is the ZIP code of your mailing address?(Required.)

*11.How many adults live in your household?(Required.)

0

1

2

3

4

5

Other (please specify)

*12.How many children (ages 0-17) live in your household?(Required.)

0

1

2

3

4

5

Other (please specify)

*13.What language is spoken most often in your home?(Required.)

English

Spanish

French

Dari

Pashto

I prefer not to answer.

Other (please specify)

14.If you previously attended an Inspiredu workshop held with one of our partners or if you were referred to us by one of our partners, please provide the name of the organization. (Example: MUST Ministries, The Bridge Inc, Gwinnett County Libraries, ICNA, etc)

15.EMAIL/PHONE/TEXT AGREEMENT -- Inspiredu uses the email address and/or phone number you provide at registration to send reminders of your upcoming workshop and ask you to confirm your attendance. We will also send an email to you after you attend.

NOTE: You do have the option to opt out of email and/or text messages by notifying us of your wish to do so upon your first receipt of either/both.

Yes - I understand the "Email/Phone/Text" policy, including the process for opting out. (You must click in the box to indicate your acknowledgment. A check mark will appear once you click.)

*16.MEDIA RELEASE AGREEMENT -- Inspiredu takes pictures and videos at our workshops for external marketing such as our social media channel and our website or reports that are shared with our funders. The photos, videos, or other materials to be used by Inspiredu do not include personal information such as name, address, phone number, etc.

Please read the following consent:

I am over 18 years of age, and I have the authority to grant this consent for myself and all family members attending this workshop with me today. By clicking the "Yes" button below, you acknowledge that you have read and agree to be bound by Inspiredu's Privacy Policy and the Media & Interview Release, each of which may be updated from time to time and effective on the date posted.

NOTE: You do have the option to opt out of pictures/videos for yourself and your family. If you wish to do so, it is your responsibility to notify an Inspiredu Staff member of your preference to opt-out of pictures/videos on the day of the workshop and sign an "opt-out" statement at that time.(Required.)

Yes - I understand and agree to Inspiredu's Privacy Policy and Media & Interview Release, including the process for opting out of photos/videos. (You must click in the box to indicate your acknowledgment. A check mark will appear once you click.)

17.CONSENT SIGNATURE - Please type the FIRST and LAST NAME of the ADULT who is providing the above consent. By typing your name here, it serves as the electronic signature for the purposes of agreeing to the terms and conditions of the Inspiredu Email/Phone/Text policy and the Media Release policy. (Note: Only persons 18 years old or older are authorized to sign this contract.)