• Participant Intake Form

    Complete the eligibility screening, review consent, and submit pre-interview demographics to schedule your confidential Zoom interview.

  • Page 1 — Welcome and Eligibility Screening

  • Do you identify as a minority woman, meaning a woman of color or a racially or ethnically minoritized woman?*
  • Do you currently hold or have you recently held a leadership role at the director level or above, such as Director, Vice President, Senior Vice President, or a C-suite role?*
  • Was that leadership role within the United States technology industry?*
  • Are you 18 years of age or older?*
  • Are you willing to take part in one confidential Zoom interview lasting about 60 to 90 minutes?*

  • Thank You - Not Eligible at This Time

  • Thank you so much for your interest in Voices at the Table. This study is seeking participants with a specific set of experiences, and based on your responses it is not the right fit this time. I truly appreciate your willingness to take part. If you know a minority woman who leads in technology at the director level or above, I would be grateful if you passed this form along to her.

  • Page 2 — Informed Consent

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year

  • Page 3 — Pre-Interview Demographic Form

  • Date*
     - -
    2 digit month, 2 digit day, 4 digit year
  • If you identify as a minority woman, please self-identify the group with which you best identify:*
  • Gender identity*
  • Veteran identity*
  • United States geographic region*
  • Should be Empty: