Citizen Profile Price: Free First Name: First Name Required Last Name: Last Name Required Date of Birth:* Date of Birth is Required Address:* Address is Required Email :* Email is Required Cell Phone:* Cell Phone is Required Place of Work:* Place of Work is Required Work Phone:* Work Phone is Required What areas of Governance are you interested in? (Check all that apply):* What areas of Governance are you interested in? (Check all that apply) is Required Accountable Governance Education Reform & Youth Development Economic Development Civil Society Capacity Building Environment & Natural Resources Inclusion & Representation Integrity & Anti-Corruption Active Citizenship & Participatory Governance Policy & Law Public Service Reform Advocacy Constitutional & Civil Rights Are you interested in volunteering?:* Are you interested in volunteering? is Required YesNot at this time Are you interested in participating in our Freedom Schools program to learn more about being an active citizen?:* Are you interested in participating in our Freedom Schools program to learn more about being an active citizen? is Required YesNot at this time Name of Company:* Name of Company is Required Are you incorporated/licensed?:* Are you incorporated/licensed? is Required Yes No Address of Company/Organization:* Address of Company/Organization is Required Name of Representative:* Name of Representative is Required Title of Representative:* Title of Representative is Required Representative Phone:* Representative Phone is Required Representative Email:* Representative Email is Required Company/Organization Phone:* Company/Organization Phone is Required Company/Organization Email:* Company/Organization Email is Required What area of governance are you/your company interested in contributing to? (Check All that Apply):* What area of governance are you/your company interested in contributing to? (Check All that Apply) is Required Accountable Governance Education Reform & Youth Development Economic Development Civil Society Capacity Building Environment & Natural Resources Inclusion & Representation Integrity & Anti-Corruption Active Citizenship & Participatory Governance Policy & Law Public Service Reform Advocacy Constitutional & Civil Rights Would your team be interested in volunteering?:* Would your team be interested in volunteering? is Required Yes Not at this time Would your team be interested in participating in Freedom Schools? (This is ORG's civic education and advocacy course):* Would your team be interested in participating in Freedom Schools? (This is ORG's civic education and advocacy course) is Required Yes Not at this time I'd like to receive ORG's monthly newsletter with updates related to my interests.:* I'd like to receive ORG's monthly newsletter with updates related to my interests. is Required Yes No Email:* Invalid Email Password:* Invalid Password Password Confirmation:* Password Confirmation Doesn't Match Password Strength Password must be "Medium" or stronger No val Please fix the errors above
