Office of Multicultural Affairs Facilitation Request
SECTION: FORM
Session Requested
*
Please Select
Social Justice 101 (60-90 minutes)
Queer 101 (45-60 minutes)
Safe Zone (2.5 hours)
Equity 101 (45-60 minutes)
Allyship 101 (30-60 minutes)
Implicit Bias 101 (1 hours)
Inclusive Language: (30-60 minutes)
Intersectionality (60-90 minutes)
Intercultural Development Inventory
Special Request or Modifications to one above
I'm unsure
Tell us more
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Not sure which session will best fit your needs? Tell us more and we will work with you to identify a session that might work best.
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What day and time are you wanting this session?
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-
Month
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Day
Year
Date Picker Icon
Hour Minutes
AM
PM
AM/PM Option
Alternative day and time for this session?
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Month
-
Day
Year
Date Picker Icon
Hour Minutes
AM
PM
AM/PM Option
What is the exact location of this session?
What technology capabilities will be provided?
computer, projector, etc.
How many participants do you anticipate
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For what group are you making the request
What is the affiliation of the participants
Staff
Faculty
Students
Student Org
Class
Community
Other
What core concepts do you hope to gain from this session
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Please note if this addressing an issues within your group
Is this session being requested as a response to any incident
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Yes
No
Please share more about the incident
*
SECTION: CONTACT 1
Name
*
First Name
Last Name
Email
*
example@example.com
Is there a different contact person for this request?
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Yes
No
SECTION: CONTACT
Contact Person Name
*
First Name
Last Name
Contact Person Email
*
example@example.com
SECTION: SUBMIT
Submit
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