Indiana AI Innovation Network Registration Form
Please complete this form to join the AI Innovation Network.
First Name
Last Name
Company/Organization Name
Email
County - in which you live Adams Allen Bartholomew Benton Blackford Boone Brown Carroll Cass Clark Clay Clinton Crawford Daviess Dearborn Decatur DeKalb Delaware Dubois Elkhart Fayette Floyd Fountain Franklin Fulton Gibson Grant Greene Hamilton Hancock Harrison Hendricks Henry Howard Huntington Jackson Jasper Jay Jefferson Jennings Johnson Joseph Knox Kosciusko LaGrange Lake LaPorte Lawrence Madison Marion Marshall Martin Miami Monroe Montgomery Morgan Newton Noble Ohio Orange Owen Parke Perry Pike Porter Posey Pulaski Putnam Randolph Ripley Rush Scott Shelby Spencer St. Starke Steuben Sullivan Switzerland Tippecanoe Tipton Union Vanderburgh Vermillion Vigo Wabash Warren Warrick Washington Wayne Wells White Whitley
Job Title
Gender - will only be used anonymously for grant tracking purposes Female Male Non-Binary I self-identify as..... Prefer not to answer
Ethnicity - will only be used anonymously for grant tracking purposes African American, Black (non-hispanic) Alaska Native Asian American Indian Asian American or Pacific Islander (non Hawaiian) I prefer not to answer Latino or Hispanic Middle Eastern Native Hawaiian Multi-ethnic/Multi-racial Other - I identify as a person of color Other - I do not identify as a person of color White, Caucasian (Non Hispanic)
Would you like to subscribe to the Index newsletter to get the latest in tech? Yes I'd like to subscribe to the TechPoint IndexNo, thank you
Comments