Your Biographical Information:
*Please enter your name as you would like it to be listed on your profile for others to see.
*Tell us how to pronounce your name, for example Gaede is pronouced GAY-dee or Anna Gehres is AN-na GAIR-is.
*Date of Birth is for demographic tracking only - if you don't want us to know your date please just enter Jan 1 and your birth year. If you don't want us to know your birth year enter 0000
*Your pronouns could be: she/her, he/him, they/ them, ze/zir, or name only
Your contact information:
*Your primary mailing address
*Your primary email address (your confirmation will be sent to this address)
*Your primary phone number, let us know if it is a mobile number and if we can text you
*Enter your secondary contact information
Emergency Contact Information:
Enter Name, Relationship,Telephone number
If you are employed, tell us the name of your employer
Additional information about your household