Toggle navigation
Contribute to the final report
Slack Install
Sponsors & Mentors
Problem Statements
News
FAQ
Contribute to the final report
Slack Install
Sponsors & Mentors
Problem Statements
News
FAQ
Thank you for being a partner or mentor for the Health Equity Hackathon! Please use this form to upload your bio and headshot/logo so we can add you to the site! If you have any questions, contact: Taylor@Energizing.health.
Add Personal Bio
Name
*
First
Last
Job Title/Industry
*
Company
*
Email
*
We will use this to send you a confirmation message, ask follow-up questions, and send general updates about the event. Your e-mail address will NOT be displayed publicly on the website.
Admin Email
If you have an administrative assistant that you would like to include in our correspondence about logistics please include their email here.
Mobile Phone
*
(in case we need to reach you on site).Your phone number will not be displayed on the website.
Work Phone
Your phone number will not be displayed on the website.
Twitter
Personal/Organization Bio
*
Your Role at this Event?
*
Emcee
Sponsor
Mentor
Volunteer
Headshot/Organization Logo
*
If you have trouble submitting the form, try attaching a smaller size image (Less than 1 MB)