Hey, nice to meet you!
Please answer the following questions pertaining to your attendance of the summit. Thank you!
Email address *
Full name *
Your answer
You can call me (preferred name):
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Please refer to me as (preferred pronoun): *
Your answer
I identify as (gender)
Your answer
I am from (city): *
Your answer
I go to (school): *
Your answer
My birthday is: *
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Are you part of a Jack chapter? *
Have you been to a Jack.org summit before?
If there were an emergency, please contact: *
Your answer
What made you want to get involved with Jack.org? How did you hear about the summit?
Your answer
We are still in the process of confirming topics for workshops. Do you have any ideas? What do you want to see being covered at this event?
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We want to make this event as accessible and inclusive as possible. If you foresee any barriers or concerns regarding your personal attendance, please let us know here! We will do what we can to accommodate.
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Do you have any dietary restrictions? We are happy to accommodate if you let us know in advance!
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Would you like to purchase a souvenir t-shirt for $25? *
Who would win in a fight, an army of small ducks, or a very, VERY large duck?
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