Equity for All Arizonans

115th Statewide Town Hall

Participant Biographical Information

Please provide the following information:
First and last name:
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Job title:
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Organization/Affiliation:
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Cell phone number:
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Email address:
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Primary mailing address:
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In which Arizona county do you primarily reside?
Have you ever attended a statewide Town Hall?
If yes, please list those you have attended.
0/500
Your education (where, when, degrees).
0/500
List the CURRENT civic and cultural organizations in which you participate, including any offices held.
0/500
List the PAST civic and cultural organizations in which you have participated, including offices held.
0/500

The following questions will assist in grouping participants in a manner that best represents a diverse cross-section for each panel.
Your Gender
0/250
Your Ethnic Group
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Your Age Group
Your occupational categories (select all that apply).
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Here are some of the questions, ideas and issues that I would like to see discussed at the statewide Town Hall on "Equity for All Arizonans"
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The discussion questions at the statewide town hall will be drafted from participant submissions.
SUBMIT SURVEY
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