Registration

Question Title

1. Personal Information

Question Title

2. Which race/ethnicity best describes you (you can select more than one)?

Question Title

3. What is your age?

Question Title

4. How did you hear about the program? 

Question Title

5. What is your current job title?

Question Title

6. Did you attend the DEI 3 part series with Robin Stacia and Vernetta Walker?

Question Title

7. Describe where you see yourself on your EDI journey (200 words or less – we are taking a range of
applicants so it is fine wherever you are) Just beginning? Have attended some programming and
starting to implement? Pretty far along and want to help others along?

Question Title

8. Describe where you see your organization…

T