National Tribal Broadband Summit Registration

DRAFT REGISTRATION QUESTIONS

NATIONAL TRIBAL BROADBAND SUMMIT

August 3, 2019

• The registration page will ask for the following details (*required):

  • Prefix

  • First Name*

  • Last Name*

  • Email Address*

  • Job Title*

  • Company/Organization*

  • Work Phone*

  • Website

• The Summit will focus on six themes. Please indicate which topics you are most interested in. (Checkboxes)

  • Planning & Implementation: Identifying needs, setting goals, creating strategies, developing a plan and leveraging data to maximize the short- and long-term educational, cultural and economic benefits of connectivity.

  • Funding Opportunities: Identifying sources of Federal, private and other programs and funding sources and leveraging these and community assets to best address strategic goals and community needs.

  • Connectivity Solutions: Exploring the various connectivity options available and identifying possible solution(s) to bring broadband to your unique community.

  • Community Engagement & Partnerships: Building and leveraging partnerships with both public and private entities to support connectivity and maximize the positive impacts of broadband access.

  • Broadband for Social & Economic Well-Being: Leveraging technology to improve health care outcomes, enhance economic development, increase community engagement and expand educational opportunity.

  • Supporting Cultural Preservation: Using digital platforms to protect and preserve culture and language, support sovereignty, history, and enhance awareness and access to cultural materials.

• I am a representative of… (radio buttons)

  • Federally-Recognized Tribe

  • Alaska Native Corporation

  • School or School District

  • Library (including Tribal)

  • Tribal Organization

  • Non-Profit Organization

  • For-Profit Organization

  • Federal, State, or Local Government

  • Other

• For those who select “Federally Recognized Tribe” they will see the following sub-question:

  • I am an elected or appointed leader within the Tribal government. (Radio buttons)

    • Yes

    • No

• For those who select “Alaska Native Corporation” they will see the following sub-question:

  • I am an elected member of the board of directors or executive leadership team. (Radio buttons)

    • Yes

    • No

• If you have a disability and require accommodation in order to fully participate in this activity, please check here. You will be contacted by someone from our staff to discuss your specific needs. (Radio buttons)

  • Yes, I require accommodations for my disability.

  • No, I do not require accommodations for my disability.