SEED Participant Information Sheet SEED Participant Information Sheet In an effort to optimize your experience in the S.E.E.D. program, please complete the following questions. Please note: completion of this form serves as a confirmation of intent to complete the program. Name First Last Choose a campus location UAMS Main Campus UAMS NWA Campus Preferred Name and Personal Pronouns:Please share. Example: Name: Amber Preferred Name: Nicole Personal Pronouns: She/Her Gender Identity/Gender ExpressionGender Expression (GE). The external manifestations of gender, expressed through such things as names, pronouns, clothing, haircuts, behavior, voice, body characteristics, and more. Gender Identity (GI). One’s internal, deeply held sense of gender. Some people identify completely with the gender they were assigned at birth (usually male or female), while others may identify with only a part of that gender, or not at all. Some people identify with another gender entirely. Unlike gender expression, gender identity is not visible to others. Male Female Nonbinary/Gender-fluid Genderqueer Other Select your racial identityFor many people, it comes as a surprise that racial categorization schemes were invented by scientists to support worldviews that viewed some groups of people as superior and some as inferior. • Race is a made-up social construct, and not an actual biological fact Racial Identity- An individual’s awareness and experience of being a member of a racial and ethnic group; the racial and ethnic categories that an individual chooses to describe him or herself based on such factors as biological heritage, physical appearance, cultural affiliation, early socialization, and personal experience. White Black or African American American Indian or Alaska Native Asian Native Hawaiian or Other Pacific Islander Bi-racial/multi-racial Other Current Department/PositionPlease list your current department and position. Email Will you need any accommodations for our virtual sessions?Example: Captioning, Large print PowerPoint, etc. Yes No Other