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Tiináwitki - CommUNITY
Registration Form
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* Indicates required question
First Name
*
Your answer
Last Name
*
Your answer
Gender
*
Male
Female
Non-binary or Two Spirit
Other:
Race
*
American Indian/Alaskan Native
Asian - Asian Indian
Asian - Chinese
Asian - Filipino
Asian - Japanese
Asian - Korean
Asian - Vietnamese
Asian - Other
Black
Native Hawaiian/Other Pacific Islander - Guamanian or Chamorro
Native Hawaiian/Other Pacific Islander - Samoan
Native Hawaiian/Other Pacific Islander - Other
White
Two or More Races (Multiracial)
Other:
Required
Hispanic, Latino/Latina, or Spanish national origin
*
Not Hispanic, Latino(a), or Spanish
Mexican, Mexican American, Chicano
Puerto Rican
Cuban
Other Hispanic, Latino, or Spanish Origin
Hispanic ethnicity unknown
Email
*
Your answer
Phone Number
Your answer
T-shirt Size
*
Youth Small
Youth Medium
Youth Large
Youth XL
Adult Small
Adult Medium
Adult Large
Adult XL
Adult 2XL
Adult 3XL
Adult 4XL
Adult 5XL
Select an answer for each of the following statements.
*
Yes
No
I agree to allow photos to be taken during the training for documentation media.
I agree to allow personal statements to be used for training documentation media.
I fully support the goal of drug-free families and communities.
Yes
No
I agree to allow photos to be taken during the training for documentation media.
I agree to allow personal statements to be used for training documentation media.
I fully support the goal of drug-free families and communities.
Are you under the age of 18?
*
Yes
No
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