JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Diversity Equity and Inclusion Training Survey
Information collected is for exclusive use by Dr. Marcus Robinson and the Social Innovation Group
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email Address
*
Your answer
Full Name
*
Your answer
Address
Your answer
Primary Phone
*
Your answer
Social Media Platforms/Handles (Should you want to share)
Your answer
Preferred Pronouns (Example: He/Him/His... She/Her/Hers...They/them/theirs)
*
Your answer
Occupation (If Applicable)
Your answer
Avocations(s) (Hobbies or other Passions)
Your answer
Military Experience (If Applicable)
Your answer
What do you want to learn most from this workshop?
*
Your answer
Have you previously attended diversity training?
*
Yes
No
If so, what worked about that previous workshop? What didn't?
Your answer
How do you hope to apply what you learn in the workshop to your life and work?
*
Your answer
What else do you want us to know and understand about you?
Your answer
If you are accepted into the workshop, are you committed to attending all three full sessions without fail? (Dates TBD)
*
Yes
No
If you are accepted into the program, do you give us full permission to use your photo, likenesses, sound and other images of you as a result of your participation in the Workshop?
*
Yes
No
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
