Name *

First Name

Last Name

Your Role *

Administrative / Field Employee

Individual Contributor

Manager

Director

Vice-President

C-Suite

Board Member

Total Number of Employees in Your Organization *

Less than 50

50 – 199

200 – 499

500 – 999

1,000 – 2,499

2,500 – 4,999

5,000 – 9,999

10,000 +

How important is diversity, equity, and inclusion to the majority of your organization's board?

Very Important

Important

Moderately Important

Of Little Importance

Unimportant

N/A – We Don't Have a Board

I Don't Know

How important is diversity, equity, and inclusion to the majority of your organization's executive team? *

Very Important

Important

Moderately Important

Of Little Importance

Unimportant

I Don't Know

How important is diversity, equity, and inclusion to the majority of your organization's management team? *

Very Important

Important

Moderately Important

Of Little Importance

Unimportant

I Don't Know

How important is diversity, equity, and inclusion to the majority of your organization's employees and/or prospective employees? *

Very Important

Important

Moderately Important

Of Little Importance

Unimportant

I Don't Know

How often does your organization invest resources (e.g. time, money) to promote diversity, equity, and inclusion in the workplace? *

Very Frequently

Frequently

Occasionally

Rarely

Very Rarely

Never

I Don't Know

Are there leaders within your organization that are ready and willing to spearhead meaningful changes? *

Yes

No

I Don't Know

Your organization is prepared to institute systemic changes (e.g. changes to policies, practices, norms) in order to foster a more equitable workplace. Do you agree or disagree? *

Strongly Agree

Agree

Slightly Agree

Disagree

Strongly Disagree

I Don't Know