SBRN's Virtual Empowerment Series (Sept 2020)
The Spina Bifida Resource Network (SBRN) is pleased to announce that our Virtual Empowerment Speaker Series for adults with disabilities will continue this September!
Please use this form to register for our upcoming virtual speakers, activities and events.
Login information for this and future events will be sent to the email you provide below.
Visit us on Facebook and check back often as SBRN will continue to add more events.
* Required
Email address
*
Your email
Which of SBRN's Virtual Empowerment Series events do you plan to attend? Choose all that apply.
Power in Purpose • Wednesday, September 23, 7pm ET
WheelLifeConnections • Wednesday, September 30, 7pm ET
Dream Big! • Wednesday, September 2, 7pm ET
#GetSocial • Wednesday, September 9, 7pm ET
Traveling with a Disability • Wednesday, September 16, 7pm ET
Other:
First Name
*
Your answer
Last Name
*
Your answer
Email
*
Your answer
Phone
Your answer
State
*
Choose
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Age (optional)
Your answer
Do you personally identify as a person with a disability?
Yes
No
Other:
Clear selection
What speakers, topics or activities would you like SBRN to offer?
Your answer
Want to join SBRN's mailing list?
Yes
No
Clear selection
Submit
Never submit passwords through Google Forms.
This form was created inside of Spina Bifida Resource Network.
Report Abuse
Forms