Climate Summit 2024 Tickets
Last Registration Day - September 27, 2024
Contact Information
Please fill name and contact information of the attendee. Each attendee must submit this form.
Your Name
*
First Name
Last Name
Email Address
*
example@example.com
Contact Number
*
Please enter a valid phone number.
Your Organization (if applicable)
Organization Name
Title
About You
We are collecting demographic information on attendees for the purpose of better understanding the Climate Summit's audience, and to help us to improve event access to the many diverse communities in San Mateo County. You may opt our of answering these questions.
What race/ethnicit(ies) do you most identify with? Check all that apply.
American Indian, Alaska Native, or Indigenous
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Pacific Islander
White
Other
What gender(s) do you most identify with? Check all that apply.
Woman
Man
Transgender
Nonbinary
Genderqueer
Two-spirit
Other
What age group do you fall within?
12-17
18-24
25-34
35-44
45-54
55-64
65-74
75+
What is your household size?
1
2
3
4
5
6+
What is your annual household income?
Less than $26,000
$26,001 - $50,000
$50,001 - $95,000
$95,001 - $149,000
$149,001 - $175,000
$175,001 - $210,000
$210,000 +
What languages do you feel comfortable communicating in? Check all that apply. Your answer will help us understand interpretation needs at the Summit.
*
English
Spanish
Mandarin
Cantonese
Tagalog
Samoan
Tongan
Vietnamese
Other
What part of San Mateo County do you live in?
*
South County (Redwood City, North Fair Oaks, East Palo Alto, Menlo Park, San Carlos, Atherton, Woodside, or nearby)
Mid County (San Mateo, Belmont Burlingame, Millbrae, Foster City, or nearby)
North County (San Bruno, South San Francisco, Brisbane, Daly City, Colma, or nearby)
Coastside (Pacifica, Montara, Half Moon Bay, Pescadero, San Gregorio, La Honda, El Granada, Loma Mar, or nearby)
I do not live in San Mateo County
If you live in San Mateo County, enter your zip code.
Please indicate any dietary restrictions so that we can accommodate you at the Summit. If you have dietary restrictions not reflected on this list, please email ana@thrivealliance.org.
*
Vegetarian
Vegan
Gluten-free/Celiac
Peanut-free
No restrictions
Your Ticket
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General Admission
$
100.00
Supporter Admission
Supporters will be acknowledged in the printed program at the Climate Summit.
$
250.00
Champion Admission
Champions will be acknowledged in the printed program at the Climate Summit, on the event website and on a thank you slide during the program.
$
500.00
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