The Changemaker Project Student Registration and Pre-Survey
This form encompasses the registration and pre-survey and is required for all students to complete before beginning the online course. These questions help us to measure our impact; thank you for taking the time to answer them thoroughly!


BEFORE BEGINNING THIS FORM YOU SHOULD HAVE THE FOLLOWING READY:

-Your team advisor's name and email
-Your team name (make it unique!)
-Your team captain's name + email (will be the main point of contact from your team)
First Name *
Your answer
Last Name *
Your answer
School email *
Your answer
Non-school email (We may need this if your school email blocks emails from outside accounts.) *
Your answer
What is the best email to reach you at? (Please retype it here and make sure to check spelling!) *
Your answer
Birthday *
MM
/
DD
/
YYYY
Age *
Are you in high school or college? *
Preferred Pronouns *
How would you describe yourself? *
Required
How did you hear about this program? *
If a specific person referred you to the program, please enter their name here:
Your answer
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