Community DEI Input form

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Community DEI Input form

This form is form the CPC community to share thoughts, ideas, and concerns directly with the CPC DEI VP.

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Name (if you are comfortable sharing)

Your answer

Would you like to remain anonymous? (aka only I would know) ( Only applicable if you put your name)

Yes

No

Other:

Clear selection

Best contact if comfortable

Your answer

Chapter

ADPi

APhi

AXO

AXID

AOE

Phi Mu

Zeta

AGD

Theta

Clear selection

Type of input

Thoughts

Concern

Idea

Other:

Clear selection

Elaborate (please be as specific as possible)

Your answer

Submit

Clear form

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