Basecamp Registration

Name *

First Name

Last Name

Phone

(###)

###

####

Please identify the policies, process, or practice you have influence over. *

Influence may mean you have oversight of the policy, process, or practice and/or you are able to shift the policy or practice as a part of your job duty.

Affirmative Action

Title VII

Title IX

ADA

504

Recruitment

Supplier Diversity

Employee Training

Conflict Mediation

Compensation

Performance Reviews

Organizational Communication

Employee Resource Groups

Social Responsibility / Community Engagement

Employee Investigations

Board Construction / Development

Fundraising

None of the Above

Other

Program Time Commitment *

Each month, Fellows are expected to invest 4 hours: 2 hours to program sessions and 2 hours of preparation for program sessions and audit work

I understand the program time commitment.

Terms of Agreement *

Please review the terms of agreement (www.deibasecamp.com/terms)

I have read and agree to the terms of agreement.

Payment Options *

The next step in the registration process is payment. Please note that your spot in the cohort is not secured until you have completed payment and received a confirmation email from our team. You have several options for how to complete payment:

ACH Payment

Bill.com Direct Payment