Building Bridges Registration: Engagement Summit for EHE Jurisdictions

SUMMIT REGISTRATION
About this Event. A day-long pre-conference Summit to the 2024 Saving Ourselves Symposium for HRSA EHE jurisdiction staff and representatives. Learn to better engage Black LGBTQIA+ communities. Explore strategies for assessing, learning, and planning for meaningful engagement of people living with HIV. Registration for SOS Conference strongly recommended for Summit attendees.

Who Should Attend? Jurisdictions are encouraged to send decisionmakers in their EHE programs--from leadership, to program staff, and community representatives who help inform jurisdictions' programs and priorities

Registration is required for this event (no cost for Summit registration).

This Summit is accompanying the SOS Conference because of its focus on Black LGBTQIA+ southerners and those who support them. Registration for the SOS Conference is strongly encouraged for all Summit attendees. Information on the SOS Conference and registration can be found here.

Summit Details: August 15, 2024 9am-4pm

SOS Conference Details: August 15-18, 2024

Location: Renaissance Atlanta Waverly Hotel & Convention Center (Atlanta)

Questions? Email outreach@southernaidscoalition.org
Attendee Information

Please take a moment to fill out the form below.
Your Name*

First NameLast Name
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Jurisdiction Represented *
Title/Role with Jurisdiction *
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What best describes your role? (Select all that apply)*

Program Director/Manager/Program OversightProgram Staff/Program ImplementationAdministrative Support to EHE ProgramsAdvisory role as community memberOther
What term(s) best express how you describe your current gender identity?

Cisgender WomanCisgender ManNon-BinaryTransgender womanTransgender manGender NonconformingQuestioning or UnsureDecline to AnswerOther or additional identity
Do you identify as a member of the LGBTQIA+ community?

YesNoPrefer Not to AnswerOther
What is your age group?

18-2526-3536-4546- 5555-6465+
Which racial and ethnic categories best describe you? Select all that apply.

American Indian or Alaska NativeBlack, African AmericanHispanic, Latino, Chicano (Etc. Columbian, Dominican, Cuban, Mexican, Mexican American, Puerto Rican, Salvadorian, etc.)AsianNative Hawaiian or other Pacific IslanderWhiteOther
Do you have any accessibility or accommodation requests?
Please share any food allergies
Would you like to join our emailing list to be notified about future upcoming events?

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I hereby grant the Southern AIDS Coalition permission to use my likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration. (If disagree, please alert hosts to be excluded in the photo)*

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Summit attendees will receive a brief assessment to complete ahead of the Summit. Do you agree to complete assigned pre-work?*

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Please verify that you are human.*
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SUMMIT REGISTRATION

Attendee Information