ACT Diversity, Equity, and Inclusion Feedback Form

As an organization, ACT celebrates our differences; seeks and continues to improve equity; and supports a culture of respect. ACT is committed to a better journey for everyone in our communities, as we strive to improve the quality of life for all people.

Please take a moment to share any questions, ideas, or feedback on ACT's DEI efforts. Your comments will be discussed with members of the DEI Committee only.

Question Title

* 1. Please share your question, feedback, idea(s), or concern(s).

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* 2. I am interested in learning how I can get more involved with ACT's DEI efforts

Yes

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* 3. Would you like a member of the DEI Committee to follow up on your comment/question?

Yes

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* 4. If you have selected that you would like a follow-up, please be sure to enter your name & email. This section is optional, though, if you would like to remain anonymous.

Name

Organization

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Thank you for submitting! If you have requested follow-up, a member of the DEI Committee will be in touch with you soon.