TGNC Leadership Space Application
137 West 19th Street, New York, New York 10011 | 646-882-2000 | translatinxnetwork.org
Name *
First and last name
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Email
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Phone number *
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Street Address *
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What is your gender identity? *
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What is your race/ethnicity? *
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What is your housing status? *
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How did you hear about TGNC Leadership Space? *
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Have you attended any groups or events at Translatinx Network before? *
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If yes, how was your experience?
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What are some of your goals? *
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What is the highest level of education you completed? *
What is your primary language? *
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How comfortable are you with: *
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What other programs, work, or commitments are you currently involved in? *
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Do you have any other concerns, things of note, or feedback? Please tell us below: *
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