CPH-NEW Survey of Advisors and Affiliates CPH-NEW Survey of Advisors and Affiliates Thank you for completing this brief survey of potential roles you might be willing to provide to support CPH-NEW over the next 2 years:1. Name(Required) First Name Middle Initial Last Name Suffix 2. Please indicate your current role with CPH-NEW (choose one):(Required) External Advisory Board Member Research Affiliate 3. Please specify your primary areas of interest in occupational health and safety:(Required) 4. Please indicate if you would no longer like to continue in your role with CPH-NEW:(Required) Happy to continue my roll Sorry, I must decline my role I am interested in supporting the Center’s work through the following activities:5. Contributing to educational outreach and dissemination activities Yes No 6. Review of draft manuscripts and/or conference presentations Yes No 7. Review of survey documents and protocols related to our research Yes No 8. Assist with relevant student training (e.g., mentoring project work) Yes No 9. Attend periodic presentations of works in progress Yes No 10. Co-author manuscripts or presentations with CPH-NEW investigators. Yes No 11. Serve as a presenter or discussant for our TRENDS webinar series. Yes No 12. Use or disseminate CPH-NEW materials (e.g., Healthy Workplace Participatory Program toolkit or Corrections health mentor toolkit)? Yes No 13. Review or pilot test new Total Worker Health program implementation tools (e.g., organizational readiness materials, senior leader training materials)? Yes No 14. Review or contribute new e-learning modules (self-paced, online learning; narrated presentations for continuing education credit)? Yes No 15. Deliver a webinar presentation for our quarterly CPH-NEW TRENDS series? Yes No If yes, please suggest topics you would like to speak about:(Required) 16. Author a CPH-NEW “News & Views” emerging topic brief? Yes No If yes, please suggest topics you would like to write about:(Required) 17. Other contributions: Yes No If yes, please specify:(Required) 18. Please let us know how much time you can contribute to CPH-NEW activities overall? No time 1-2 hours/month 3-4 hours/month 5-10 hours/month 19. Please describe any ways that CPH-NEW could be more helpful to you in your work? 20. Are there any other comments or information you would like to share with us? Thank you very much for your responses!PhoneThis field is for validation purposes and should be left unchanged.