Statement of Interest for Employee Resource Groups (ERG)

Please review the eligibility requirements and expectations for the Employee Resource Groups (ERG) before submitting the application below.

Program Eligibility

Any UW Health & SMPH employee* who meets the following requirements is encouraged to apply
At least 0.5 FTE
Supervisor signature of support for participation
Continues to meet eligibility requirements throughout participation in the program

*Employees in training and student employees are not eligible. Staff, including postdoctoral fellows and graduate students with appointments such as teaching assistant or research assistant, and faculty are eligible.

Participant Expectations

Communicate continuously with supervisor regarding ERG attendance
Commit to continued growth and personal development throughout the tenure of time on the ERG
Uphold the Conversation Agreements, confidentiality of others, and of UW Health & SMPH
Discuss concerns or possible changes to participation with co-chairs

Participant’s Supervisor Expectations

Make participant available to attend and participate in meetings (1-2 hours a month) on paid time
Support the participant’s ongoing growth and personal/professional development
Contact Afra Smith, DEI Program Consultant, at ASmith9@uwhealth.org with questions or concerns about participation in the ERG
Notify Afra Smith, DEI Program Consultant, at ASmith9@uwhealth.org if the participant’s eligibility changes at any time during and/or after the application and selection process

Before submitting a statement of interest

Communicate with your supervisor about your interest in joining an ERG. After you hit submit, they will receive an email with instructions on how to approve your involvement. They must complete this for you to join.
Know that if you are selected to participate in this ERG, you will need to work with your supervisor to ensure you get paid to attend these meetings times if they take place outside of your regularly scheduled work hours.

ERG charters

Review the charter for the ERG you are expressing interest in:

Employee Resource Groups (ERG) Statement of Interest

Full name(Required)

First Last

Date(Required)

Employee NetID(Required)

Job title(Required)

Unit(Required)

Department, Institute, Center, Office, etc.

Email(Required)

Date of hire(Required)

Use first of the month if exact date is not known.

Supervisor's name(Required)

First Last

Supervisor's phone(Required)

Supervisor's email(Required)

I am applying for membership to the:(Required)

LGBTQ+ ERG (QUILTBAG)

Women’s Leadership ERG

Black/African/African American ERG

Military Service Membership ERG

LatinX ERG

Asian/Asian American/Pacific Islander ERG

Email Afra Smith (asmith9@uwhealth.org) to apply for the Resident & Fellow (BIPOC) ERG

Are you interested in joining the selected ERG because (please choose one):(Required)

I am interested in joining as a member of the demographic

I am interested in being an ally to this group

What are your goals for participating in this ERG?(Required)

How will your unit/supervisor support your involvement?(Required)

I am aware of the responsibilities, time commitments, and expectations associated with ERG membership:(Required)

I understand that I will be contacted through email and will be provided with upcoming meeting dates. I will work with my supervisor to identify how to fit this involvement into my work calendar. I understand that the operational needs of my unit may impact my eligibility to be selected to participate in the ERG this year.

My checking this box indicates that I have read and agree to all expectations.