JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
BRIC Institute - Save the Date - Nov. 7-9, 2024
Thank you for your interest in the BRIC Institute. We look forward to collaborating with you to create
a world where the individual and community trauma of Bullet-Related Injuries (BRI) are met with transformative care and healing.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Name
*
Your answer
Email
*
Your answer
City/Community
*
Your answer
Organization (if applicable)
Your answer
Experience/Expertise (check all that apply)
I have or my family has been impacted by Bullet Related Injury (BRI).
I am a health care provider.
I support people with BRI but am not a health care provider.
I am a health or justice policy professional or decision maker.
I work or live in Missouri.
I am part of the St. Louis, MO community.
Other:
I plan to attend:
all or part of the Institute in-person.
only the Virtual Keynote on November 8.
Clear selection
If you are responding for a group, how many people plan to attend in-person?
Your answer
If you are responding for a group, how many people plan to attend the virtual keynote?
Your answer
What else would you like to share with us?
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Power4STL.
Report Abuse
Forms
