Children's Bureau's National Child Welfare Center for Innovation and Advancement, Non-Public Event Registration

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Activity Title
Date & Time
Month Day, Year XX:XX (a.m./p.m.) in (TimeZone)
Description
[Displayed for PIING Events] The National Child Welfare Center for Innovation and Advancement Peer Innovation and Insight Networking Groups (PIINGs) leverage peer connections to exchange best practices to improve child welfare systems. Our PIINGs provide a national platform to exchange insights and knowledge to improve jurisdictional performance and develop and implement innovative strategies and solutions to advance outcomes for children and families. 
After registering, you will receive an email with a calendar invitation containing the link to the activity.
Event Registration
First Name (Open Text)
Last Name (Open Text)
Email Address (Open Text)
In which jurisdiction do you primarily work? 
(Select one.) [single-select dropdown of all jurisdictions] 
            i. Not applicable
            ii. Alabama
            iii. Alaska
            iv. American Samoa
            v. Arizona
            vi. Arkansas
            vii. California
            viii. Colorado
            ix. Commonwealth of the Northern Mariana Islands
            x. Connecticut
            xi. Delaware
            xii. District of Columbia
            xiii. Federated States of Micronesia
            xiv. Florida
            xv. Georgia
            xvi. Guam
            xvii. Hawaii
            xviii. Idaho
            xix. Illinois
            xx. Indiana
            xxi. Iowa
            xxii. Kansas
            xxiii. Kentucky
            xxiv. Louisiana
            xxv. Maine
            xxvi. Marshall Islands
            xxvii. Maryland
            xxviii. Massachusetts
            xxix. Michigan
            xxx. Minnesota
            xxxi. Mississippi
            xxxii. Missouri
            xxxiii. Montana
            xxxiv. Nebraska
            xxxv. Nevada
            xxxvi. New Hampshire
            xxxvii. New Jersey
            xxxviii. New Mexico
            xxxix. New York
            xl. North Carolina
            xli. North Dakota
            xlii. Ohio
            xliii. Oklahoma
            xliv. Oregon
            xlv. Pennsylvania
            xlvi. Puerto Rico
            xlvii. Republic of Palau
            xlviii. Rhode Island
            xlix. South Carolina
            l. South Dakota
            li. Tennessee
            lii. Texas
            liii. U.S. Virgin Islands
            liv. Utah
            lv. Vermont
            lvi. Virginia
            lvii. Washington
            lviii. West Virginia
            lix. Wisconsin
            lx. Wyoming
            lxi. Other 
            lxii. Other: (open text)
For which organization do you work? (open text)
What is your current title? (open text)
What best describes your role in child welfare? 
(Select one) [single-select dropdown of all jurisdictions] 
    a. State agency leadership
    b. State agency staff
    c. County agency leadership
    d. County agency staff
    e. Court Improvement Program director or staff
    f. Legal/judicial partner
    g. Family and youth leaders/representatives
    h. Federal staff
    i. State or county contracted provider
    j. Technical assistance provider
    k. Territory child welfare leadership and staff
    l. Tribal program leadership
    m. Tribal program staff
    n. University/college partner
    o. Other/NA: (open text)
[Depending upon the nature of the gathering for which people are registering, no more than two additional questions of the following may be added]
To optimize the outcomes of this session, please answer the following question[s] to help us with our planning. 
To strengthen learning, breakouts will be formed around the following topics. Please select your first-choice breakout topic: [single-select; drop-down menu of topics customized to the PIING]
We plan to host voluntary office hours in the [timeframe]. Please indicate topics that you might want to discuss during office hours. [single-select; drop-down menu of topics customized to the PIING]
We are looking for volunteers to share their experiences doing [brief description of topic] in their jurisdiction. If you are willing to share, may we contact you to discuss the opportunity further? 
Yes / No
What is one thing you’re hoping to take away from this session? (open text)

Click to register.