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I would like to register for this event as:
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An In-Person Attendee
A Remote, Live-Stream Attendee
Registration Fee for both in-person and live-stream registrants
*
$5
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Registration
Contact Information
Name
*
First Name
Last Name
Email
*
Verify Email
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Address
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Please keep me connected with what's happening at Groundwork:
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Yes!
No, thanks!
Thanks, I'm already connected!
I would like to support Groundwork with a donation:
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Yes
No
Donation Amount
$100
$50
$25
$
Would you be willing to answer 3 questions to help us with a grant requirement?
Yes
No
What is Your Age?
0-12 years old
13-25 years old
26-54 years old
55 years or older
Military Service
I am currently serving in the military
I have a family member who currently serves in the military
I am retired from military service
I have a family member who is retired from military service
N/A
What is Your Gender?
I identify as male
I identify as female
I identify as nonbinary
Add 3% to my total amount to help cover the payment processing fees