Membership Demographic Survey
We have been asked by the United States Breastfeeding Committee (USBC) to provide some demographic information about our members. This information could also be used when applying for grants and the like. This information will NOT be sold.
All questions are optional.
What is your name?
Your answer
What is a good phone to reach you?
Your answer
What is a good email to send you updates?
Your answer
What is your gender?
What is your age?
Your answer
Which of these do you identify with?
Do you identify as LBGTQ?
Are you an adoptive or foster family?
Are you interested in becoming a Board Member?
Are you interested in helping with any committees or projects? (i.e. Membership, The ABC Conference, Social Media, etc)
Are you an IBCLC?
Are you a CLC?
What is your current profession?
Your answer
Thank you for filling out our survey
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