Moms Who Lead With Love Member Engagement Survey
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1.
What is your full name? (First and Last)
(Required.)
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2.
What is your email address?
(Required.)
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3.
What is your location? (City, State)
(Required.)
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4.
What is your ethnicity?
(Required.)
Hispanic or Latino or Spanish Origin
Not Hispanic or Latino or Spanish Origin
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5.
What is your race?
(Required.)
American Indian or Alaska Native
Asian or Asian American
Black or African American
Native Hawaiian or other Pacific Islander
White
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6.
How many kids do you have?
(Required.)
1
2
3
4
5
6+
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7.
How old are they?
(Required.)
1-3
4-6
7-10
11-13
14-17
18+
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8.
What level of engagement are you currently interested in? (Multiple selections available)
(Required.)
I am interested in contributing financially.
I am interested in participating in a committee.
I am interested in joining and participating in a local chapter of Moms Who Lead With Love, should they be created.
9.
Please list any skills or talent you’d be interested in offering to MWLWL.
Current Progress,
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