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Networks Interest
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* Indicates required question
Email
*
Your email
Causes:
For Whom Does Your Heart Break?
Check All That Apply
*
Young children (0-3)
Children (4-8)
Children (9-12)
Youth (13-18)
Young Adults (18-25)
Trauma
Disability
Senior Care
Single Parents
Mental Health
Human Trafficking
Families in Poverty
Addiction/Recovery
Immigrants/Refugees
Family Homelessness
Children in Foster Care
Domestic Violence and Abuse
Foster/Adoptive/Kinship Parents
Kids who have aged out of foster care
Other:
Required
Geography: Where You Live
What city and suburb do you live in?
Is there an existing community-connecting network that you are a part of?
*
Your answer
Workplace and Industry:
Organization, Title, and Industry
*
Your answer
Affinity: Catch-All
Is there another area of passion or focus that you'd like to gather people towards to influence positive change?
*
Your answer
Which Network(s) Are You Most Interested In?
*
Your answer
Optional:
What are your strengths in helping a network form, sustain and flourish?
Your answer
Name
*
Your answer
Preferred medium for connecting
*
Zoom
Phone
In-Person
Asynchronously over email or audio messages to begin
Other:
Required
Timeframe for connecting
*
ASAP
Within the next couple weeks
Flexible for a couple months
No rush, just eventually
Other:
Required
What else would you like to share?
Goals, purpose, questions, etc.
Your answer
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