Memorandum of Agreement (6/2025)

Memorandum of Agreement (6/2025)
Please select one:*

I am signing on behalf of myself, as an individual not affiliated with any organization/group.I am signing on behalf of my organization, as a leader of my organization with decision-making power to delegate staff to Norwalk ACTS areas of work.
I hereby acknowledge that I have read, understand and agree to the terms of this Memorandum of Agreement regarding membership to Norwalk ACTS.*

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We are collecting racial/ethnic identity information about our individual membership to ensure our initiatives and working groups are representative of the Norwalk community at-large. The information collected will support our north star goal of co-creating solutions with our community and achieving racial equity in Norwalk. We acknowledge that the listed categories do not represent all identities of the community and have provided "other" categories for any information not included. This question is not required to become a member of Norwalk ACTS. Please select the racial category or categories with which you most closely identify with:

American Indian or Alaska NativeAsian or Pacific IslanderBlack or African AmericanHispanic or Latin(x)White or CaucasianOther
Employer Individual
Listing your employer and/or affiliated organizations groups and groups does not mean you're working on behalf of these groups. Signing this MOA individual means you are acting on your behalf.
Role/Title Individual

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