Equity Committee by WIELD Membership Form
Sign in to Google to save your progress. Learn more
Your Name *
What are your preferred pronouns? *
Email *
Have you attended previous WIELD Events (i.e. Fall Events, Speakeasy, HHs)? If so, which ones? *
What do you wish to gain from joining the WIELD Equity Committee? *
We value representation and encourage visibility.  Please help us move the needle through data-driven design.  This data is solely for Equity Committee membership metrics and will NOT be shared.  Please let us know if we are misrepresenting any options below.  We consider our education to be an ongoing process.  **Your responses to the below questions will not impact membership.  Membership is open to all.**
All of the below questions are optional.
In which profession do you currently practice?
How many years have you been established in your profession?
Clear selection
Do you have any of the following accreditations? Check all that apply.
Which race do you identify with?  Check all that apply.
Which gender do you identify with?
How do you identify (i.e. homosexual/gay, heterosexual/straight, bisexual, pansexual, etc)?
Are you civilian, veteran, or currently on active duty?
Do you have a superpower (i.e. wheelchair racer, attention super focus, ASL fluent, graphic design, IG influencer)?
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