Application Form for Mental Health Employee Resource Group (ERG) Community
Hello! Thanks so much for your interest in Mind Share Partners' virtual community for mental health ERG leaders and members.

This community is specifically for individuals employed at a company and who is leading or a member of an ERG focused on mental health, neurodiversity, and/or disability (or thinking about creating one internally).

This community is intended to:
a) Provide helpful information for those leading or supporting mental health ERGs at companies
b) Create a platform for members to connect, learn, and support each other

After completing this form, we will be in touch with additional information about how to join. If you have any questions, please reach out to
Your email address *
Your first & last name *
Your company *
Your personal LinkedIn page -OR- company's LinkedIn page *
What city and state (or country) are you based in?
Name of your ERG (if relevant)
Do you hold a leadership role in your ERG?
Clear selection
How would you best describe the focus of your ERG? If other, please specify.
Is your ERG company-wide or specific to a location or department? If the latter, please specify in the "Other" field.
Clear selection
Approximately how many people does your ERG serve? In other words, your company size, department size, location size (NOT the size of your ERG). Enter in number form (e.g., "1000").
Which of the following best describes the stage of your mental health ERG or mental health-related content and programming?
Clear selection
How large is your team that is leading your ERG planning and activities? (Please enter in number form). If solo, enter 1.
How many hours per week do you personally spend on ERG-related activities? This includes admin-related work as well such as emailing, planning, etc. (Please enter in number form).
What is your ERG's current budget?
Do you or your ERG have support from your company’s executives or senior leadership?
Clear selection
How closely do you work with the following for your ERG-related activities and planning?
They’re in most meetings and emails
They are tapped when needed or relevant
They are not very involved
I am a part of this team
Executives or senior leaders
HR or people teams
Clear selection
If you are thinking about creating a mental health ERG, where are you currently at in its formation? Describe in 1-2 sentences (e.g., developing a business case, trying to get buy-in from leaders, waiting to talk to HR, etc.). If you have created an ERG already, skip this question.
Please rate your company’s culture around mental health.
Clear selection
As we grow the ERG community, what level of participation would you be most interested in? (Select all that apply). Please provide additional ideas in the "Other" field.
What topics are of most interest to you? (Select all that apply). Please also provide additional topics of interest in the "Other" field.
Would you like to be included in our directory of mental health ERG community members?
Clear selection
Are there any other thoughts or questions you would like to share?
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