Name *

First Name

Last Name

Where Would you want us to host the event next year? *

South Atlanta

Outside Metro Atlanta

Cobb County

Gwinnett County

Dekalb County

Hall County (Gainesville)

Fulton County

Describe yourself, mark all that apply *

Entrepreneur/Business Owner

Student

Nonprofit professional

Corporate/Business executive

Government executive

Other

Topics I would like to see next year in the program *

Community members with different abilities or disabilities

Mental health

Unaccompanied minors and separated families

Students rights in school

Issues around access to healthcare

Parenting

Youth & Millenials

Earlier education

Healthy relationships

Other