Study on Men Faculty Allies: Participant Demographic Survey

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for your willingness to participate in this study. Please complete this brief survey to ensure you fit the study criteria. If you meet the study criteria, the researcher will follow up with you to schedule a one-hour interview within 24 hours of form submission. If you have any questions, please contact Danielle Lewis, PhD student, at dvegas@buffalo.edu

Name *

Email *

Institution *

Discipline that you teach in *

Please select your academic rank. *

Please indicate the length of time (in years) you have been at your current institution

Please select your race.

Do you identify as Hispanic, Latino/a or Spanish?

No, I do not identify as Hispanic, Latino/a or Spanish

Yes, I do identify as Hispanic, Latino/a or Spanish

Prefer not to answer

Clear selection

Are you a U.S. citizen?

Yes

Prefer not to answer

Clear selection

Please indicate your age below.

Please select the gender identity that most closely aligns with how you identify? *

Gender Non-conforming/Non-binary

Intersex

Man

Woman

Prefer not to answer (If you choose this option, you will not be eligible to participate in this study.)

Required

Do you identify as Trans*

Yes

Prefer not to answer

Clear selection

Please select the sexual orientation with which you identify?

Asexual

Bisexual

Fluid/Pansexual

Heterosexual

Homosexual

Queer

Prefer not to answer

Please indicate whether you identify as an ally using the formal definition follows: Allies must maintain membership in a dominant group, possess an awareness of one’s own privilege, and actively advocate against inequity and the systemic oppression of underrepresented populations (Bishop, 2002; Broido, 2000; Patton & Bondi, 2015) *

Yes, I identify as an ally for undergraduate women in STEM

No, I do not identify as an ally for undergraduate women in STEM (If you choose this option, you will not be eligible to participate in this study.)

Unsure (If you choose this option, you will not be eligible to participate in this study.)

If you have recommendations for other individuals who fit the study criteria, please list their name and email or institution below. (Study criteria follows: 1.) individuals who self-identify as men 2) hold any type of faculty position in a STEM discipline at an institution of higher education that has received a NSF ADVANCE grant and 3) attest that they identify as an ally for undergraduate women in STEM will be considered as participants)

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms