Roosevelt Network Training Request Form
Street Address Line 2
State / Province
Postal / Zip Code
LinkedIn Profile URL (if you have one):
An undergraduate student in the Roosevelt Network
A student not part of the Roosevelt Network
An alumni of the Roosevelt Network
A partner of the Roosevelt Network or Roosevelt Institute
Graduation Year/Expected Graduation Year:
Have you attended a different college/university previously? If so, please list it here:
Position/Role in Chapter:
Chapter Head (President)
E-Board Member, General
E-Board Member, Policy Director
I am requesting access to the trainings for:
To deliver to my Roosevelt chapter
To deliver to members of another organization
To deliver to members of my Roosevelt chapter and other students
Anything else you want us to know about your involvement with the network and/or your request for access to our trainings?
Contact Record Type
Please note that demographic information is not required.
Race/Ethnicity (select all that apply):
Native American/Alaskan Native/Indigenous
Do you identify as a person of color?
Do you identify as LGBTQIA?
Are you a first generation college student?
Do you, or have you ever, attended community college?
Have never attended
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