CDI Diversity Workshop/Training Request

Form

Name
Department
Phone Number
Email Address
Requested date of workshop
Requested time of workshop
Location of workshop
Would you like the training to be held in the Center for Diversity and Inclusion? (UC South B12)
Length of time allotted for workshop
Number of students/attendess present
Describe the participant population  (i.e. diverse student group including international students or ony non-trad students)
Will AV equipment be available?
Please list three intended learning outcomes for your training.