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Your interest in Inclusion, Diversity and Health Equity is appreciated! Thank you and please remember that signing up for an ERG is voluntary. We are grateful for your interest.

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* 1. What is your first name?

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* 2. What is your last name?

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* 3. Please provide your Stanford email address to receive ERG related information.

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* 4. Please select any or all of the ERG(s) that you are interested in.

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* 5. Would you like to be an ERG member or leader?

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* 6. Please select below if you work at any one of the following locations.

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* 7. Anything else you'd like to share?

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