Rural Pride Summit for California/Cumbre del Orgullo Rural de California

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Please use this form to register for the California Rural Pride Summit during the week of September 21, 2020. Once we receive your registration, we will be in touch with details about how to join each event during the week.

Usar esta forma para registrarse para la Cumbre Virtual del Orgullo Rural de California que sucedará la semana de 21 de Septiembre, 2020. Cuando recibimos su registración, te contactaremos con detalles explicando como unirse para cada evento en la semana.

Email *

Name/Nombre *

Phone number (optional)/Teléfono (Opcional)

Location (county/town/city)/Ubicación (condado, pueblo, ciudad) *

Location (state)/Estado *

Please check any of the following that apply to you / Por favor elige todo debajo que se aplique a tí:

Person of color/Persona de color

Native/Indigenous/American Indian/ Indígena/Indígena Americana

Transgender/Transsexual/Transgénero/Transsexual

Under 25/Menor de 25 años

Over 55/Mayor de 55 años

Person with disability/disabilities / Persona con discapacidad/discapacidades

Medical professional/Médico Profesional

Attorney/Abogado

Other Legal Professional/Otra Profesión Legal

Student/Estudiante

Immigrant (born outside the U.S.)/Inmigrante (nacido fuera del EEUU)

None of the above/Ninguna de las anteriores

NCLR and CRLA are committed to making this event accessible to as many people as we can. Do you have any accessibility needs or requests that you want us to know about ahead of time?

NCLR y CRLA son comprometidas en asegurar que este evento sea accessible por la mayor cantidad de personas posibles. ¿Usted tiene una necesidad de accesibilidad o solicitud que usted quiera que sepamos antes del evento?

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