Thank you for contacting the Office of Diversity, Equity and Inclusion to support your program, initiative, activity or event geared towards advancing diversity and inclusive excellence in the Carver College of Medicine (CCOM). Your request will be reviewed within 2 weeks of submission. Should your request be funded, you will be required to submit an evaluation of your program, initiative, activity or event within 30 days. If funds are provided to support professional development, the attendee(s) will be asked to provide an overview of the experience (and/or give a talk if applicable). Who is requesting funding? Today's Date Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20212022202320242025 Name * Email * Department Program/Activity/Event Description Date of Proposed Program/Initiative/Activity/Event Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Year Year20212022202320242025 Description of Program/Initiative/Activity/Event Which CCOM strategic diversity goal will this Program/Initiative/Activity/Event support (select all that apply) Attract, recruit, retain and successfully graduate a diverse body of students, trainees, residents and fellows. Attract, recruit, promote and retain a diverse faculty and staff workforce. Increase and maintain diversity in leadership and management. Foster a culture where everyone who works and learns within the CCOM feels included, valued and respected. Enhance and promote cultural competency and/or cultural awareness of CCOM learners, faculty and staff. Create an inclusive and diverse academic/research environment. Sponsor educational programs designed to inform the community on a wide range of diversity issues in healthcare and/or biomedical research. Describe how this program/initiative/activity/event will support your department's and the CCOM's strategic diversity plan. Expected Outcomes Estimated Number of Attendees or Participants (if applicable) Estimated Total Budget Indicate the amount that your department/unit is contributing toward this program/initiative/activity/event Funding Requested from OCADI How will the money be used? Additional Comments CAPTCHAThis question is for testing whether or not you are a human visitor and to prevent automated spam submissions. What code is in the image? * Enter the characters shown in the image.