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Bringing Diverse People Together in Unity

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Name of your group?*

Purpose of your group?*

Do you have a parent organization? If so, explain your affiliation.*

What is your group's mailing address, include city, state and zip?*

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What is your group's phone number?*

Area Code

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What is your group's email address?*

What is your group's website?*

Contact person's name?*

First

Last

Contact person's phone number, if different from the group.*

Area Code

Phone Number

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1. Please answer the following question:*

Our group is not diverse.

Our group is diverse.

2. Please answer the following question:*

Our group is newly formed.

Our group has operated for some time.

Number of people in your group who plan to participate in UP?*

How did you hear about Visible Unity?*

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