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General Registration
Planning Team
Which convening are you registering for?
San Diego region – Tuesday, March 25
Los Angeles region – Wednesday, March 26
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Which convening are you registering for?
San Diego region – Tuesday, March 25
Los Angeles region – Wednesday, March 26
Both
First Name
Last Name
Email Address
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City
Zip code
Race/ Ethnicity - We are committed to understanding the demographic diversity of our event, tailoring user experiences and services, and addressing gaps in representation.
American Indian or Alaska Native (AIAN)
Asian
Black or African American
Hispanic or Latino
Middle Eastern or North African (MENA)
Native Hawaiian or Pacific Islander (NHPI)
White
Prefer not to say
Gender - People use lots of different terms to describe their gender. Of the response options listed, which one best describes your gender select one only
Woman or female
Man or male
Non-binary
Transgender woman or female
Transgender man or male
I use another term (please specify)
Prefer not to say
I use another term (please specify)
Company
Job Title
Affiliation (Company, Association, University, etc)
What sector does your organization primarily work in?
Academia
Community-based organization
Consulting
Developer
Federal government
Finance / Banking
Local government
Non-profit
Philanthropy
Regional government
State government
Technical assistance provider
Tribal serving organization
Tribal government
Union
Utility or Community Choice Aggregators (CCA)
Youth
Economic/ Community Development Organization
Which region(s) of California does your organization primarily serve?
North Coast
Central Coast
Sacramento Valley
Sierra Nevada
San Francisco Bay Area
San Joaquin Valley
Los Angeles
Inland Desert
San Diego
State of California
Which best describes the type(s) of communities your organization serves?
Rural
Suburban
Urban
Tribal
All of the above
Which issue areas are the primary focus of your organization?
Agriculture
Economic / Community Development
Climate
Environmental Justice
Energy
Funding
Housing
Natural Resources
Public Health
Racial Equity
Social Infrastructure (technical assistance, capacity building, etc.)
Transportation
Youth
Other
Would you be willing to join a panel, breakout session, or discussion to share your experience or success during the Convening on one of the topics you selected in the previous question?
Yes
No
Has your organization applied for a SGC or LCI grant or program? (As a lead applicant or partner)
Yes
No
Please list what programs you have applied for.
If your organization has received a LCI or SGC grant or participated in a program, please list them here.
Are you registered with a tribal entity?
Yes
No
Which tribal entity are you registered with? You are welcome to also share your position in the tribe here.
Are you interested in a travel honorarium? Staff will follow-up with you and provide more information on available honorariums. Honorariums are limited.
I am representing a community-based organization or tribal entity and am interested in a travel honorarium.
I am representing local government, academia, or a non-profit entity and am interested in a travel honorarium.
I do not need a travel honorarium.
Please indicate if you have any ADA requirements
Yes
No
If Yes, please explain
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