Personal Information

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* 1. First Name:

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* 2. Last Name:

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* 3. Email Address:

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* 4. Phone Number:

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* 5. Race or Ethnicity: (Please select all the groups that reflect how you identify.)

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* 6. Gender Identity: (Please select one.)

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* 7. Do you identify as Lesbian, Gay, Bisexual, or Queer+?

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* 8. Age:

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* 9. Your organizational role/title:

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* 10. How long have you served in this role?

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* 11. Are you a first-time Executive Director?

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