Shedd Aquarium Auxiliary Board
Prospective New Member Application
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Current Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Current Employer
*
Job Title
*
Birthday
*
/
Month
/
Day
Year
Date
LinkedIn profile URL:
*
Gender Identity
*
Female
Male
Prefer not to say
Prefer to self-identify
Which of the following best describes your ethnic heritage? (Please select all that apply)
*
Alaska Native, American Indian, or Indigenous
Arab or Middle Eastern
Asian or Asian American
Black, African American, or African origin
Latino/a, Latinx, Hispanic or Spanish origin
Native Hawaiian or Pacific Islander
White (Non-Hispanic)
Multiracial
Prefer not to answer
Other
Were you referred by a current Auxiliary Board or Board of Trustees member?
*
Yes
No
Name of referrer
*
Are you currently a member or volunteer of Shedd Aquarium?
*
Yes
No
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Tell us about yourself
What is your background, career interests, hobbies, etc.?
*
Why are you interested in serving on the Shedd Aquarium Auxiliary Board?
*
How do you believe you can contribute to the Shedd Aquarium Auxiliary Board's mission?
*
What is your favorite animal at Shedd Aquarium? Why?
*
Is there anything else you would like to share with us?
*
Submit
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