CNC Membership Demographics

CNC Member Demographic

As a non-profit agency that relies on community, corporate, and foundation support, the below information is required from all individuals who wish to utilize the Career & Networking Center's resources as a member. Please note, the reports generated are on the collective demographics of our members, therefore, your personal information will not be shared with any third party that would identify you with specific responses. Thank you!
Membership Level*
Membership Date*

MonthDay Year
Date
E-mail*
example@example.com
Phone Number*
Name*

First Name Last Name
Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
County*
Township*
Do you live in:*
Employment Status*
Birthdate*

MonthDay Year
Date
Gender*
Race/Ethnicity*
Marital Status*
Head of Household*

YesNo
Number of individuals in household*
Current Total Household Income*
Recent Graduate (Within the last 2 years)*

yesno
Military Veteran*

YesNo
How did you hear about us?*
If referred by an agency or business, please share name.

My Products*

CNC Membership

$100.00

Enter coupon

Total

$0.00

Please check you email upon completion, for our mandatory Member Agreement Form, which highlights our fees and expectations.
Should be Empty:

CNC Member Demographic