Name *

First Name

Last Name

Phone

(###)

###

####

I identify my race/ethnicity as *

choose all that apply

American Indian/Native American

Asian Indian

Asian

African-American/Black

Native Hawaiian/Pacific Islander

Latino/Hispanic

White

I am interested in

choose all that apply

Being a virtual mentor for a dietetic student/intern/young professional

Writing a post for the Diversify Dietetics blog

Participating as an expert in a Diversify Dietetics IG/FB live session

Being interviewed for the RDN Spotlight series

Participating in a Diversify Dietetics webinar

Hosting a Diversify Dietetics meet-up in my city

All of the above (at some point- we won't ask you to do all at once!)

In your opinion, how can your College/ University help reduce barriers for underrepresented ethnic/racial groups interested in the field of dietetics?

choose all that apply

Create/Revamp written goals surrounding diversity

Initiate mentoring programs for underrepresented groups

Evaluate the success of current efforts

Provide scholarship or grant opportunities

Provide additional assistance and/or coaching for the Dietetic Internship admissions process

Provide networking and experiential learning activities

Improve cultural sensitivity of our faculty, staff and advisors

Based on your previous answer, which initiative(s) rank as a high priority

Select up to three

Create/Revamp written goals surrounding diversity

Initiate mentoring programs for underrepresented groups

Evaluate the success of current efforts

Provide scholarship or grant opportunities

Provide additional assistance and/or coaching for the Dietetic Internship admissions process

Provide networking and experiential learning activities

Improve cultural sensitivity of our faculty, staff, and advisors