Join the ARC Network Form

Full Name *

First Last
E-mail *
example@example.com
Phone Number
Organization
Job Title
Website
What state do you currently reside in?

Street Address

Street Address Line 2

State
How would you describe your career level? *

Early Career Mid-Career Senior Career Retired Not listed (please specify)
How would you describe your sector of employment? *

Academia Government Industry/Business Military Non-profit Self-employed Unemployed Not listed (please specify)
What is your race and/or ethnicity?

Below are the categories traditionally collected by the U.S. Census. We are providing these options so that we can compare our membership to national trends; however, we recognize that these categories are limited and, as such, provide additional space for you to tell us about your heritage, nationality, and ethnic- and racial- identity in addition to these options and welcome suggestions you have to make this list more comprehensive.
How would you describe your racial and/or ethnic identities? (check all that apply) *

Asian or Asian American Black or African American Chicana, Chicano, or Chicanx Hispanic Jewish Latina, Latino, or Latinx Middle Eastern or Middle Eastern American Native Alaskan Native American or American Indian Native Hawaiian Pacific Islander White or Caucasian I’d prefer not to share this information with you Not listed (please specify)
Regardless of whether you have gone through a formal process or received a diagnosis, do you have a disability or chronic condition or experience normative environments as disabling? *

Yes No I’d prefer not to share this information with you Not listed (please specify)
How would you describe your gender? (check all that apply) *

Agender Gender non-conforming Genderqueer Man Non-binary Pangender Transgender Woman I’d prefer not to share this information with you Not listed (please specify)
How would you describe your sexuality? *

Asexual Bisexual Gay Heterosexual or Straight Lesbian Man loving man Pansexual Queer Questioning Woman loving woman I’d prefer not to share this information with you Not listed (please specify)
How did you hear about the ARC Network? *

From WEPAN Communications From ARC Network Communications From official NSF ADVANCE communications From the ADVANCE Listserv At a conference From a colleague From an internet search Other
ARC Network Communications

Yes, I would like to receive information about ARC Network publications, news, and events.
Program
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