Implications Wheel Event Registration
Name:
E-mail:
Phone:
Company:
Title:
The following demographic information will be used to ensure a diverse distribution for participant groups.
Gender:
Select One
Female
Male
Age Groups:
Select One
16-21
22-30
31-55
56-75
Education:
Select One
Completed High School
Some College
Completed College
Completed Graduate Degree
Completed Doctorate
I am a?
Select One
Parent of a school-age child
Current K-12 student
Teacher
School administrator
Higher education teacher or administrator
Business owner or other employer
Taxpayer
Media
Other
I am willing to participate as a laptop operator, as needed.
(Laptop operators should be familiar with basic business office software and agree to arrive 1 hour prior to the scheduled event time to load software and receive operating instructions.)
For laptop volunteers only.
I have been previously trained as an operator
Select One
Yes
No
I will provide my own laptop for the event.
