TGNC Leadership Space Application
137 West 19th Street, New York, New York 10011 | 646-882-2000 | translatinxnetwork.org

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Name *
Email
Phone number *
Street Address *
What is your gender identity? *
Required
What are your pronouns? *
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What is your race/ethnicity? *
Required
What is your housing status? *
Required
How did you hear about TGNC Leadership Space? *
Required
Have you attended any groups or events at Translatinx Network before? *
Required
If yes, how was your experience?
What are some of your goals? *
What is the highest level of education you completed? *
What is your primary language? *
How comfortable are you with: *
Needs assistance
Fair
Comfortable
Reading English
Writing English
What other programs, work, or commitments are you currently involved in? *
Do you have any other concerns, things of note, or feedback? Please tell us below: *
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