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)
Non-school email (We may need this if your school email blocks emails from outside accounts.)
What is the best email to reach you at? (Please retype it here and make sure to check spelling!)
Are you in high school or college?
Graduate School (master's)
Graduate School (phD)
Graduate School (professional/law/other)
How would you describe yourself?
American Indian or Alaska Native
Black or African American
Native Hawaiian or Other Pacific Islander
Hispanic or Latino
How did you hear about this program?
The Pollination Project
If a specific person referred you to the program, please enter their name here:
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