DEI Alliance: New Member Interest Form

✻ = Required

Registration

First and Last name ✻

Email ✻

Why are you interested in being a member of the DEI Alliance? (check all that apply). ✻

Individual learning and/or personal accountability Professional development opportunities Connect with others doing similar programmatic work focused on DEI Support institutional change at ANR Other…

If you checked "Other" above, feel free to comment here. ✻

The DEI Alliance is currently focused on racial equity, but hopes to expand its focus in the near future as membership expands and capacity increases. What other areas of equity work would you like to see the DEI Alliance engage? Are you willing/able to help facilitate any of these efforts? ✻

This section is optional, and will help us plan future outreach and activities. There are no wrong answers, just information that will help us better meet the needs of all our members.

Please share any of your identities that you feel are relevant to the efforts of the DEI Alliance (e.g. race/ethnicity, (dis)ability/neurodiversity, language(s) spoken, gender identity, sexual orientation, immigrant, religious affiliation/or lack of, refugee, etc). If you do not feel comfortable sharing this information, please let us know that instead. ✻

Please briefly describe any efforts you have made to advance equity in your personal or professional life. If you are new to this work, please describe what you are most interested in learning. ✻

Job Title ✻

Other comments? ✻

By submitting this interest form, joining and participating in the DEI Alliance, you agree to uphold the UC ANR Principles of Community, DEI Alliance Group Agreements, and commit to active growth and/or involvement in the areas of diversity, equity, and inclusion.

DEI Alliance Group Agreements can be found here: https://docs.google.com/document/d/12vBXZ0ULPOmVXoj2av29jRzTprKCGn7vvhphEBkI5_I/edit?usp=sharing

If you have questions or comments, you can contact the DEI Alliance Coordination & Outreach Committee by emailing Jodi Azulai (jlazulai@ucanr.edu), Belinda Messenger bmsikes@ucanr.edu.

To show you're not a robot, add this code: 4DEI ✻