ImmunoX DEI Initiative Interest Form

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Join the movement and become an ImmunoX DEI ally, through learning and providing support to underrepresented minorities. Let's make diversity, equity and inclusion part of ImmunoX culture and create a stronger community!

First Name *

Last Name *

Pronouns

You identify as (check all that apply, optional). [Note "cis" refers to individuals that identify to the sex assigned at birth]

Woman

Man

Trans

Cis

Non-binary or gender fluid/neutral

Prefer not to say

Other:

Do you identify as a Queer/LGTQIA+ (optional)

Yes

Prefer not to say

Clear selection

Do you identify as a person with a disability?

Yes

Prefer not to say

Clear selection

Email *

What is your lab? (in other words, what is your PI's name) *

Position at UCSF *

Graduate Student

Postdoc

Lab Scientist

Lab Technician

Faculty

Staff

Other:

You identify as: *

Black/African-descent diaspora

Indigenous/Native American

White

Pacific Islander

Asian

Latinx/Hispanic

Prefer not to say

Other

Required

How would you categorize your interest in ImmunoX's DEI Initiative?

I want to join the movement and become an ImmunoX ally for Diversity, Equity, and Inclusion

I’d like to join the conversation

Submit

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