Clone of NH QR thrive forms

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

What best describes why you're reaching out today? (Select the option that best fits.)* This field is required.

Bias or discrimination

Exclusion or bullying

Harassment or inappropriate behavior

Accessibility concern

Looking for EDI resources or support

Mental health or wellness support

I have a suggestion to improve inclusion on campus

other

4

Please tell us more about your experience or concern. * This field is required.Please share as much or as little as you're comfortable with

5

How can we best support you?* This field is required.(Select all that apply.)

I'd like information about available campus resources.

I'd like someone from SSF to contact me.

I'd like to be connected with the appropriate Seneca department or service.

I'd like to share feedback to help improve campus inclusion.

I don't need follow up; I just wanted to share my experience.