MEMBER INFORMATION SURVEY
Please take your time to fill out the following information so we can best leverage your super powers (strengths, location, affiliations, network, etc.)  The more information we have on the people who join our group the easier it will be to know what resources we have to tap into in order. Most questions are optional but please press "Submit" to ensure the data sends.  

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WHO, WHAT, WHERE?
NAME
Email address
Country of Residence
City and State/ Province/ Territory
 Connection to PD
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