Staff Contact Survey Last Name * Legal First Name * "Go-by" Name If different from legal first name Middle Initial * Committees and Roles Select all that apply Director/Co-director Treasurer Secretary Knowledge Management Supplies & Inventory Program & Speaker Recruitment Fundraising & Donor Relations Date of Birth * MM DD YYYY Preferred Email * Email linked to Google account? * Yes No, but I'll get it linked Huh? Help please! Cell Phone * (###) ### #### Mailing Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Home Address If different from mailing address Address 1 Address 2 City State/Province Zip/Postal Code Country Comments Thank you! Click here to return to Staff Corner
