DEI Webinar Intake Form | Diversity Way-Maker

Your Company’s Structure

Private, Small (under 500 employees)

Private, Large (over 500 employees)

Small nonprofit

Large nonprofit

What Industry Are You In?

Employee Type?

Full Time

Part Time

Contract

Fractional

If you are in leadership, what level of leadership are you in?

Salary Range?

Do you serve on any boards or committees internally?

YES

NO

Reason for Registering?

To advance my career

To become a more accountable leader

My company recommended my attendance (or offer CEUs)

I’m interested in getting certified in DEI

Do you hold any DEI certifications or degrees

YES

NO

How often a year are you investing in your professional development?

Less than one time a year

1-3 times a year

More than three times a year

Who covers the cost?

I cover all costs

I cover costs, and then I am reimbursed

My company covers the cost for me

Would you like to hear about our certification program for becoming a Diversity Way Maker?

Yes, I am interested

I am interested, but tell me more about it

Not at this time

Webinar Intake Form