First Name: *

Last Name: *

G Number: *

Campus Address: *

Department: *

Job Title: *

Job Type: *
Staff Faculty

Start Date with GVSU: *

Are you tenured? *
No Yes

Have you attended an Institute for Healing Racism program? *
No Yes

What year did you attend? *
1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024

With whom did you attend? *

Please state why you would like to become an inclusion advocate: *

Please list your previous work, service or learning experiences that are related to advocating for inclusion (across any dimension of diversity, including: age, color, disability, familial status, height, marital status, national origin, political affiliation, race, religion, sex/gender, sexual orientation, gender identity and expression, veteran status, or weight etc.): *

Please describe the strengths you bring to this role: *

Please list any other information you feel is relevant:

Which role are you applying for? *
Inclusion Advocate (must meet program learning requirements (attend orientation, an Institute for Healing Racism and bi-annual meetings) and attain tenure (for faculty) or complete probationary status and 12 months of service (for staff)
Inclusion Champion (may be non-tenured or on probation)