A critical part of the Organization for Human Brain Mapping’s strategic initiatives is to develop a plan that will ensure diversity, gender inclusivity and cultural engagement exists within OHBM’s activities and in particular the Annual Meeting.  This plan should further advance the Organization’s enduring mission to create a wholly diverse, engaged, inclusive international community of those dedicated to using neuroimaging to discover the organization of the human brain. 

* 1. Name and Credentials (i.e., MD, PhD, etc.)

* 2. Country of Residence

* 3. Country of Birth

* 4. Email Address

* 5. Position

* 6. Gender

* 7. Please write a statement as to why you are interested in serving on the Diversity and Gender Task Force. 

* 8. Please list any relevant experience and/or engagement that you may have regarding diversity and gender issues.