SD EPSCoR Discount Demographic Survey
Please fill out the form below. Once you have filled out this form, we will refund you the $25 discount to the account used to pay for registration.

Your answers will be shared with SD EPSCoR as part of a requirement for their funding. The only required information is your name and your hometown.

Name
Your answer
University Email
Your answer
What University do you attend or work at?
Your answer
Are you a
What is your ethnicity? (If you prefer not to answer, please enter 'abstain'.)
Your answer
Submit
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