BIFAD Stakeholder Database Opt-In Form

3/2/23, 9:28 AM

Connect with the Board for International Food and Agricultural Development (BIFAD) (2)

Connect with the Board for
International Food and Agricultural
Development (BIFAD)
OMB: XXXX-XXXX
Expiration Date: XX/XX/XX
Thank you for your interest in BIFAD. If you would like to receive updates on upcoming BIFAD
events and the latest BIFAD-supported reports and resources, please share your information
below.
BIFAD is committed to increasing diversity, equity, inclusion, and access in the board's
engagement and in global development more generally. This effort can be enhanced with
reliable information about our stakeholders. If you choose to respond to all or some of the
questions, information will remain confidential, with individual information not reported beyond
the project team.
Paperwork Reduction Act Statement:
A federal agency may not conduct or sponsor, and a person is not required to respond to, nor
shall a person be subject to a penalty for failure to comply with a collection of information
subject to the requirements of the Paperwork Reduction Act unless that collection of information
displays a currently valid OMB Control Number. The OMB Control Number for this information
collection is XXXX-XXXX. Public reporting for this collection of information is estimated to be
approximately one minute per response.
Fields with (*) denotes a required field.
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Connect with the Board for International Food and Agricultural Development (BIFAD) (2)

1

First or Given Name: *

2

Family or Last Name: *

3

Professional or Work Email: *

4

What is your current gender identity? *

Woman/girl
Man/boy
Additional gender identity
Prefer not to answer

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Organization Name: *

6

Organization Type (select most relevant response below): *

Prefer not to answer
U.S University
University outside the U.S
U.S. Agency for International Development 
Other U.S Government
Non-U.S Donor Organization
Non Profit Organization
Firm
Publicly Traded Company
Independent Consultant
Other

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For faculty, staff, and students of U.S universities only, is your university
identified as any of the following Minority Serving Institution (MSI) types?

Alaska Native-Serving Institution (ANSI)
Asian American and Native American Pacific Islander-Serving Institution (AANAPISI)
Historically Black College or University (HBCU)
Hispanic-Serving Institution (HSI)
Native American-Serving Non-Tribal Institution (NASNTI)
Native Hawaiian-Serving Institution (NHSI)
Predominantly Blank Institution (PBI)
Tribal College or University (TCU)
No
I do not know

8

What is your country of residence?

Select your answer

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Connect with the Board for International Food and Agricultural Development (BIFAD) (2)

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If you selected the United States of America as your country of residence, what
are your racial and ethnic identities? (please select all identities with which you
identify)

Prefer not to answer
Asian
American Indian or Alaska Native
Black or African American
Hispanic or Latino
Native Hawaiian or Pacific Islander
North African or Middle Eastern
White

10

What is your age group?

Prefer not to answer
18-24 years old
25-29 years old
30 years or older

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Connect with the Board for International Food and Agricultural Development (BIFAD) (2)

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*
By selecting "YES" below, you are opting in to receive email communication from BIFAD
or the BIFAD Secretariat. You may opt out of future communications by contacting
[email protected] from your subscribed email, noting "unsubscribe" or "optout". Your information will not be shared outside of this purpose.
Thank you for signing up to receive occasional updates and opportunities to connect
with BIFAD. Please direct any questions about this form to: [email protected].

Yes

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