Thanks for connecting with the Equity, Diversity, Inclusion & Anti-racism (EDI-R) Office; we're here to support you.

About the Intake Form

The purpose of this form is to help us direct your needs to the appropriate persons within the EDI-R Office.

Process Overview

  1. Complete the intake form below
  2. All requests will be reviewed by Jermal Jones, Manager of the EDI-R Office who will direct your request to the appropriate member(s) of the EDI-R team
  3. You will receive a response within 5 business days through the preferred avenue of communication (unless no response needed has been indicated) and together with your assigned team member, you will identify next steps and agree to the terms of support

Information and privacy: questions regarding the collection of information on this form can be directed to the form administrator.

 
1 Start 2 Complete
Who is this request for? * (required)
Type of request * (required)
Please share as much as you feel comfortable
Please share as much as you feel comfortable
How would you like for us to respond to you? * (required)
(Name you'd like to be referred to in the consultation)
Pronouns
Select all that apply
What is your primary role on campus? * (required)
Select all that apply
Which Faculty, Affiliated and Federated Institutions of Waterloo or Satellite Campus are you from?
Select all that apply
e.g. Centre for Extended Learning, Writing and Communications Centre
e.g. Catering & Event Services, Print + Retail Solutions
e.g. School of Architecture, Department of Biology
e.g. Centre for Groundwater Research, Water Institute
This could include printouts of email, Facebook messages, text messages, letters, photos, etc.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png txt pdf doc docx ppt xls xlsx mp3 zip.