Speaker Form - New York Music Month

MOME seeks to ensure that speakers represent diverse backgrounds, identities, and characteristics. Your answers will be kept anonymous and reviewed in the aggregate to help us evaluate whether we’ve met that goal.Answers to these questions are voluntary, if you do not wish to answer, select "prefer not to say".

How would you describe yourself?

To which gender do you most identify?

Do you identify as someone with a disability?

Comments

This field is for validation purposes and should be left unchanged.

African American / African / Black / Caribbean
Asian / South Asian / Southeast Asian / East Asian
Hispanic / Latinx / Chicanx
Middle Eastern / North African (MENA)
Multiracial
Native American / Alaska Native / Indigenous / First Nations
Native Hawaiian / Pacific Islander
White / Caucasian
Prefer to self identify
Prefer not to say
Other

Male
Female
Non-binary
Agender
My gender is not listed
Prefer not to answer

Yes
No
Prefer not to say