Participation Form
Email address *
Phone Number *
Your answer
What is the name of your organization? *
Your answer
Where is your organization located? *
Your answer
What is your organization's mission? *
Your answer
What is your organization's geographic reach? *
Your answer
What is your organization's IRS designation? *
Your answer
What is your organization's total number of staff? *
Your answer
What is your organization's board size and who is the board chair? *
Your answer
What is your organization's website address?
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What are your organization's social media handles?
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What are the technology capabilities of your organization? *
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Does your organization hold any national memberships or affiliations? *
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Please provide the name, phone number and email address for the primary contact person at your organization. *
Your answer
Briefly describe how the work of your organization contributes to the advancement of women and girls throughout the Connecticut. *
Your answer
Why does your organization desire to participate with the Connecticut Collective for Women and Girls? *
Your answer
How did you hear about the Connecticut Collective for Women and Girls? *
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