Amplify Membership Registration

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Your First Name *

Your Last Name *

Your Pronouns

When we refer to you in the third person, which pronouns should we use? E.g. she/her, he/him, they/them, ze/zir.

Your Email *

The email address we should use to contact you about this application. We recommend using a personal email, not work.

Company/Organization name

We collect this information to identify our range of represented organizations among our volunteers, and to help identify any potential conflicts of interest.

Do you give Amplify the right to contact you with news and event updates? *

Yes

Do you identify as part of an underrepresented group in technology? *

All are welcome to volunteer. If you identify as underrepresented, we'll ask a few more questions in the next section to help us ensure diverse representation on our board.

Yes

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