Student Volunteer Form - humanizED Podcast
The HumanizED Podcast has launched! Listen here: http://humanizED.csuci.edu

I am looking for CI student volunteers to speak with me about their experiences in college. If you complete this form, I will arrange a 30-minute online conversation with you.

If you have any questions, contact me at mpb@csuci.edu or 408-807-9377.

Michelle Pacansky-Brock
Host, HumanizED Podcast
Innovations Lead, CSU Channel Islands

Last Name
Your answer
First Name
Your answer
Email
Your answer
Phone
Please include a mobile number so I can text you if we have a problem with our meeting time.
Your answer
Are you at least 18 years of age?
Consent to Name Use
Please indicate if you would prefer me to use your real name or a fictitious name if I use clips from our conversation in a future podcast episode.
Consent to Name Use
Please indicate if you would prefer me to use your real name or a fictitious name if I use clips from our conversation in a future podcast episode.
Consent to Recording
When we speak, I will record the conversation. Please indicate below that you consent to the recording.
Which of the following describes you?
Please select all that apply.
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