MTPC Focus Group Sign-Up
Thank you for your interest in MTPC's community focus group! Please answer the following questions and if you have any questions, feel free to email Tre'Andre (he/they) at TreAndreValentine@masstpc.org.
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What name do you go by (first and last)? *
What pronouns do you use?
What is your email address? *
What organization are you affiliated with?
What is your age? *
Required
What is your gender identity? (check all that apply). *
Required
If you checked prefer to specify, what is your gender identity?
What is your race? (check all that apply) *
Required
If you checked prefer to specify, what is your race?
What is your zip code? *
(It's ok if you do not have a zip code, just write N/A)
Have you been involved in MTPC previous to your interest in the focus group? *
If you answered "yes" to the previous question, how have you been involved with MTPC in the past? (check all that apply).
If you checked prefer to specify, how have you been involved with MTPC in the past?
Please indicate your availability for the following dates. Focus group sessions are on Tuesdays from 6-7 PM. Each focus group will only have 6 participants, so please check all dates that you are available. *
Required
What accommodations do you need to attend the virtual meeting?
Anything else you'd like us to know?
Thank you so much for filling out this form! We'll get back to you soon.
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