EEB Climate Feedback Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

The purpose of this form is to provide you with the opportunity to share feedback on the EEB Department's efforts to build a supportive and welcoming community.

Your anonymous feedback will be read by EEB's IDEA committee. If you would like a response or reply, please add your contact information so that we can follow up.

Feedback/Comment/Question/Suggestion concerning Departmental Climate: *

Name (optional)

Email Address (optional)

Would you like to be contacted for follow up?

Yes

Only if it's deemed necessary by the department

Clear selection

Would you like to set up a one-on-one appointment with someone on the IDEA committee?

Yes

Clear selection

What happens to this information?

Your response will be kept confidential within the limits of the EEB department chair, EEB department manager, and the Inclusion, Diversity, Equity and Action Committee, unless it falls under mandatory reporting. To learn more about mandatory reporting, please visit https://titleix.ucsc.edu/reporting/index.html

If you witness any improper or disrespectful behavior, we encourage you to report it to one of the following entities:

https://titleix.ucsc.edu/reporting/index.html - report an incident of hate or bias
https://titleix.ucsc.edu/ - report sexual/gender harassment, discrimination, and assault; dating and domestic violence; stalking; invasion of sexual privacy
https://diversity.ucsc.edu/ - report diversity-based discrimination

The IDEA committee would love to hear from you in person. If you would like a meeting, please let us know! Meetings can be arranged with faculty, grad students, undergrad students, or staff on the committee. You must submit your name and contact information for us to email you to schedule a meeting time.

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of UC Santa Cruz. Report Abuse

Forms