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TEMPLATE - Welcome form

Let’s get to know you!

This information helps us connect with you — and connect you with your cohort.
Name(Required)
If you go by something other than what you listed above, please let us know here.
We want to pronounce your name correctly! Please write it phonetically. For example: hay-SOOS dell-RIO; or KIR-sten SHOE-berg.
Mailing address(Required)
Introduce yourself in 250 words or less! Feel free to describe your professional experience and also include any other aspects of yourself you want to share.
Max. file size: 31 MB.
You know that photo of yourself you love to look at, where you look just exactly like YOU? Please share that photo with us.
Want to connect on social media?(Required)
We'd love to share that you are part of CU. If you'd like to be tagged in posts, please let us know which social media handles you use.
Media release(Required)
I permit that Citizen University may take photographs and videos of me and/or record quotes by me for promotional purposes. I allow my name to accompany these assets. They would be used with the intent of amplifying participants’ work or promoting Citizen University programs.

Let’s get your travel logistics set

Help us book arrangements for your time with CU.
Do you require flight and hotel arrangements?(Required)
This will be set as your preferred airport. Provide city and airport code (e.g. Seattle - SEA).
Please provide city and airport code (e.g. Seattle - SEA).
What is the full name that appears on your ID?(Required)
What is your sex as it appears on your ID?(Required)
MM slash DD slash YYYY
What is your seat preference?(Required)
Check all that apply — we'll do our best to accommodate you!
Do you have any airline mileage accounts?(Required)
Do you have TSA Pre✓?(Required)
Do you have any general hotel preferences or needs we should know about?(Required)
For example: an accessible room, on a low floor, etc. Note: We will book your hotel and email you the details once they are confirmed.
We will do our best to accommodate these.

Emergency contacts

Who should we be in touch with in the unlikely event that something goes wrong?
Contact name(Required)

Organizing an healthy, joyful, and accessible experience

We strive to host inclusive, accessible experiences that enable all participants to engage fully, including individuals with disabilities, faith or cultural considerations, or any specific access needs. Participation will involve logistics of all kinds — from transportation to/from the airport, hotel, meeting space and restaurants; to a full schedule each day; to use of slides and audio-visual media, printed materials; and many things in between. We will do our best to organize the experience responsively with this information in mind.
Do you have any access requirements you would like us to be aware of as we plan for our time together?(Required)
Do you have any food allergies we should be aware of?(Required)
We will be providing breakfasts, lunches, dinners, and snacks over the course of our time together.
Do you have any other dietary restrictions or eating preferences?
If Halal or Kosher certified foods are not available, how do you typically supplement/replace these foods?
Salty or sweet, we want to know!
Do you have any environmental or medical allergies we should be aware of?(Required)
As a group, we may do outings around town — we want to help keep you safe. If your food allergy is also environmental (i.e. cannot be around peanuts), please note here as well.
Be as specific as possible. You may also list preferred alternatives if you’d like. Please also note if you carry an epi pen for this allergy.
This field is for validation purposes and should be left unchanged.

We envision a great civic revival across our nation — our dream is a country in which Americans are steeped in a sense of civic character, educated in the tools of civic power, and are problem-solving contributors in a self-governing community.

Contact
300 Lenora St. #1391, Seattle, WA 98121
[email protected]
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Citizen University is a 501 (c)(3) non-profit organization, EIN 46-4270721. Content by Citizen University is licensed under CC BY-NC-ND 4.0.

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Site Navigation

  • About
    • Our Work
    • Civic Culture
    • Staff & Board
    • Jobs & Internships
    • Financials & Reporting
  • Programs
  • Spread Citizenship
    • Teach Power + Character
    • Host Civic Saturdays
    • Spark Citizenship
    • Reimagine Fourth of July
    • Take the Sworn-Again Oath
  • Get Inspired
  • Donate