Planning Series Contact informationName(Required) First Last Email(Required) I would like to join the Quivira Coalition email list. Yes Phone(Required)Mailing address(Required) Street Address City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Only your city and state are required by Quivira. If you prefer not to give the other information, write, "N/A" in those fields.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 above organization or affiliation(Required) 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 email@example.com.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? Event-specific informationAdditional InformationDo you require special accommodations or have access needs you'd like us to be aware of? Yes No While we cannot accommodate all access needs we will do our best! We will reach out with any additional questionsPlease describe your requested accommodations or access needs below:How did you hear about this workshop/event?(Required) Word of mouth Quivira social media Quivira website Quivira Newsletter Down to Earth Podcast Radio ad Print flyer Newspaper Other Are you a member of the Quivira Coalition? Yes No Knowledge inventory/Pre-event surveyAre you willing to engage in a quick knowledge inventory/pre-event survey?YesNoAnswering these questions helps us measure the impact of our programming. Thank you in advance!