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* 1. What is your name?

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* 2. What is your role at CCA?

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* 3. What department do you work in?

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* 4. What is your CCA email address (or best email address) so we may contact you?

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* 5. Please rank the following Task Force goals in order of your interest (most interest at the top, least interest at the bottom):

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* 6. Please write a bit about why you are interested in joining the LGBTQIA+ Task Force:

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* 7. What experiences, skills, and/or strengths can you bring to this Task Force and our goals of:
- increasing LGBTQIA+ visibility on campus
- educating and fostering understanding
- providing support and resources
- and advocating for the LGBTQIA+ community?

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* 8. Would you have any interest in seeing, building, and/or joining a LGBTQIA+ Affinity Group at CCA?

(This would be a space that is committed to providing professional development, networking, and community building opportunities for the LGBTQIA+ self-identified faculty, staff, and instructors at CCA.  This is different than the existing Task Force as you do not have to belong to the LGBTQIA+ community in order to serve on the Task Force and meet the goals.)

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