GRLN Change Champion Interest Form

Your Name

Your Pronouns

UCSF Email Address

Title

Department

To which of the following groups do you belong at UCSF?

Select all that apply.

Location

Change Champion Interest

Why are you interested in serving as a Change Champion for the Gender Recognition and Lived Name policy at UCSF?

Please let us know how you heard about this opportunity.

I understand the time commitment of serving as a change champion is expected to be 1-2 hours per month.

Form Date Field

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Send me a copy of my responses

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