Name
First Name
Last Name
Email Address
*
City/Municipality
*
Province
*
What best describes your position in the nutrition/dietetics profession as of today?
*
check all that apply
If other please describe
If you are currently a dietitian, what do you do?
If you are currently a dietitian, what areas of practice do have experience in?
if other, please describe
I am interested in
*
choose all that apply
What race/ethnicity do you self-identify as?
*
choose all that apply
if other please describe
Age
Under 20
20-25
26-30
31-35
36-40
41-45
46-50
51 - 60
61+
What gender do you self-identify as?
What are/were some of the challenges you experienced while pursuing your dietetics education?
if other, please describe
What are ways that you would like to be supported in the field of dietetics?
This can be broad like community support, or specific like passing the CDRE
Subscribe me to the Diversify Dietetics Monthly Newsletter
Yes
No
If there is a fellow Diversify Dietetics community member thta is looking to connect with someone like you can we provide them with your email address?
Yes
No
What expectations (if any) do you have of the Diversify Dietetics Canada Community? What do you hope to experience or participate in?
Instagram
LinkedIn
Please share any ideas for blog post, webinars, or IG/FB lives! We are looking for any resources that you may want as a current or future dietetics student/intern/young professional or resources that you feel are needed for RDNs (of all ethnicities/races) who are teaching, hiring or mentoring dietetics students/young professionals of colour.
