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Work With Us
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Get in touch with Club Connect
Club Connect Interest Form
Name
*
First
Last
Last
Email
*
Phone
About me:
*
I'm an individual interested in joining Club Impact
I'm an individual/organization interested in collaborating with Club Impact
Where I'll be joining from:
Clackamas County
Multnomah County
Washington County
Other
Where I'll be joining from:
How I plan to attend Club Connect:
Smartphone
Tablet
Laptop
Home computer
The device I'll connect with is:
My device
Someone else's device
My connection options:
My own wifi connection
Someone else's wifi connection
Hot spot
I'm interested in these Club Connect activities:
Socializing / Conversation
Games
Cooking
Guest Speakers
Watching Videos / Movies
Other
Other
Is there anything else you'd like us to know?
If you are human, leave this field blank.
Submit
