mentorship field day Contact informationName(Required) First Last Email(Required) Phone(Required)I would like to join the Quivira Coalition email list. Yes Your Location City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State Organizational informationOrganization affiliation(Required)Name of ranch, farm, organization, agency, institution, etc. with whom you are affiliated. You're also welcome to put NA if you're coming as yourself!Role at organization or affiliationLunch PreferencesWe will provide free lunch to all attendees. Lunch will be grilled beef or lamb hamburgers with a veggie burger option. Sides will be baked beans, chips, and farm vegetables.Please indicate what you'd like for lunch:(Required) Beef hamburger Veggie burger I will provide my own lunch Do you have any food allergies we should know about?(Required) Yes No Please tell us about any food allergies and we will be in touch to make sure you have a lunch option.LodgingThe hosts of this event have graciously offered about 8 beds for guests to use on 6/27 and/or 6/28 in a large historic ranch house. There will also be ample spots available for camping.While you do not need to have your lodging plans sorted out at this moment, would you like to request a bed at the ranch?(Required) No Yes, for 6/27 Yes, for 6/28 Yes, for 6/27 and 6/28 Would you like information about camping? Yes No Demographic informationThese questions will help us at the Quivira Coalition continue to improve antiracism, diversity, equity, and inclusion in all our programs. Certain questions are optional: you are not required to enter a response about your gender, race, ethnicity or access needs. If you have suggestions or resources you would like to share, please email us at newagrarian@quiviracoalition.org.I (or my organization) most strongly identify with the following group(s):(Required) Academic (student/researcher/instructor) Established rancher/farmer/producer Beginning rancher/farmer/producer Government agency Nonprofit/foundation Business Tribal (member/leadership/entity) Media Interested youth (25 and under) Other What gender do you identify with?Do you identify as BIPOC (Black, Indigenous, and/or other Person of Color)? Yes No With what race(s) and/or ethnicity(ies) do you identify?Additional InformationHow did you hear about this workshop/event?(Required) Word of mouth Regenerate conference outreach Quivira newsletter Quivira Social Media Down to Earth Podcast Other Do you require special accommodations or have access needs you'd like us to be aware of? Yes No Maybe The workshop will include walking around the land, which may involve climbing, bending, and/or crouching. While we cannot accommodate all access needs, we will do our best! We will reach out with any additional questions.Please describe your requested accommodations or access needs[Optional] Please include any other information we should know.NameThis field is for validation purposes and should be left unchanged. Δ
