GOLDEN interest form
The Genetics Opportunities, Learning, Development and Empowerment Network (GOLDEN) is a genetic counseling (GC) awareness and mentoring initiative primarily geared toward Black undergraduates and post-baccalaureates. Please complete this form if you have an interest in becoming a genetic counselor and want to join GOLDEN. Grace-Ann Fasaye and Barbara Harrison, GOLDEN's co-founders, can be contacted at geneticsgolden@gmail.com with any questions.
Sign in to Google to save your progress. Learn more
Full Name
What is your hometown zip code?    
What is your race/ ethnicity?
If you are currently a student, indicate what level
Clear selection
What is the name of your school? (N/A if not in school)
Are you currently working or have worked in the past as a Genetic Counseling Assistant?
Clear selection
Are you currently working or have worked in the past as a research assistant or a post- baccalaureate trainee?
Clear selection
How did you hear about the GOLDEN Program?
Clear selection
Are you currently undergoing the GC graduate school application process?
Clear selection
As a prospective genetic counselor, what types of support are you looking for? Check all that apply
What topics would you like addressed during group mentoring sessions?
Please provide your email address (required)
Please provide your cell phone number (optional)
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms