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Masterclass - Registration
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Name
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First Name
Last Name
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Email
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example@example.com
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3
Which best describes you?
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Startup Hub / Coworking Space
Corporate
Government / Civil Service
Investor
Professional Services
Programme Manager / Innovation Lead
Educational Provider
Student
Startup
Other
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Company
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Your
role
in {company}
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6
Which county are you based in?
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Not based on the Island of Ireland
Antrim
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Carlow
Cavan
Clare
Cork
Derry/Londonderry
Donegal
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Dublin
Fermanagh
Galway
Kerry
Kildare
Kilkenny
Laois
Leitrim
Limerick
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Mayo
Meath
Monaghan
Offaly
Roscommon
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Tipperary
Tyrone
Waterford
Westmeath
Wexford
Wicklow
Please Select
Please Select
Not based on the Island of Ireland
Antrim
Armagh
Carlow
Cavan
Clare
Cork
Derry/Londonderry
Donegal
Down
Dublin
Fermanagh
Galway
Kerry
Kildare
Kilkenny
Laois
Leitrim
Limerick
Longford
Louth
Mayo
Meath
Monaghan
Offaly
Roscommon
Sligo
Tipperary
Tyrone
Waterford
Westmeath
Wexford
Wicklow
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7
Where did you hear about this course?
*
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Dogpatch Labs website
NDRC website
News Article
Newsletter
Referral
Social Media
Women Entrepreneurs Network
Word of Mouth
Other
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8
What is
one skill/learning
you would like to get from this Masterclass?
*
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9
Data Privacy (
https://ndrc.ie/privacy-policy)
*
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I agree to the sharing of my data with NDRC
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10
Are you attending this Masterclass
virtually
or
in person
?
This Masterclass will be hybrid, offered virtually through
Zoom
and also
in-person at PorterShed a Dó
(15 Market St, Galway, H91 TCX3).
In-person
Virtually
In-person
Virtually
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11
Do you have any
accessibility requirements
?
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No
Yes
Please Select
Please Select
No
Yes
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12
Please specify your
accessibility requirements
*
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13
Edition
Masterclass #1
Masterclass #2
Masterclass #3
Masterclass #4
Masterclass #5
Masterclass #8
Masterclass #9
Masterclass #10
Masterclass #11
Masterclass #12
Masterclass #13
Masterclass #14
Masterclass #15
Masterclass #16
Masterclass #17
Masterclass #18
Masterclass #19
Masterclass #20
Masterclass #21
Masterclass #22
Masterclass #1
Masterclass #2
Masterclass #3
Masterclass #4
Masterclass #5
Masterclass #8
Masterclass #9
Masterclass #10
Masterclass #11
Masterclass #12
Masterclass #13
Masterclass #14
Masterclass #15
Masterclass #16
Masterclass #17
Masterclass #18
Masterclass #19
Masterclass #20
Masterclass #21
Masterclass #22
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14
Registration type
Pre-registration
Pre-registration
Pre-registration
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15
Gender
Please specify your gender pronouns.
Woman (she/her)
Man (he/him)
Non-binary
Other
Prefer not to say
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16
Racial/Ethnic Identity
Asian
Black
Irish Traveller
Latin American
Middle Eastern
White
Other
Prefer not to say
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17
Do you have a disability (visible or invisible)?
Yes
No
Prefer not to say
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18
Would you like to join
NDRC's Mailing List
to stay in the loop about future Masterclasses and programmes?
*
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YES
NO
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