Study on Men Faculty Allies: Participant Demographic Survey
Thank you for your willingness to participate in this study. Please complete this brief survey to ensure you fit the study criteria. If you meet the study criteria, the researcher will follow up with you to schedule a one-hour interview within 24 hours of form submission. If you have any questions, please contact Danielle Lewis, PhD student, at 
Name *
Email *
Institution *
Discipline that you teach in *
Please select your academic rank. *
Please indicate the length of time (in years) you have been at your current institution
Please select your race.
Do you identify as Hispanic, Latino/a or Spanish?
Clear selection
Are you a U.S. citizen?
Clear selection
Please indicate your age below.
Please select the gender identity that most closely aligns with how you identify? *
Do you identify as Trans*
Clear selection
Please select the sexual orientation with which you identify?
Please indicate whether you identify as an ally using the formal definition follows: Allies must maintain membership in a dominant group, possess an awareness of one’s own privilege, and actively advocate against inequity and the systemic oppression of underrepresented populations (Bishop, 2002; Broido, 2000; Patton & Bondi, 2015) *
If you have recommendations for other individuals who fit the study criteria, please list their name and email or institution below. (Study criteria follows: 1.) individuals who self-identify as men 2) hold any type of faculty position in a STEM discipline at an institution of higher education that has received a NSF ADVANCE grant and 3) attest that they identify as an ally for undergraduate women in STEM will be considered as participants)
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy