(*) denotes required information.

Thank you for your interest in utilizing the Office of College Life for your diversity programming needs. In order to expedite your request, please complete the form below, review it for accuracy, then click the submit button. Completion of this form does not guarantee that a request can be filled. However, we will make every effort to secure a facilitator or Diversity Peer Educators to fill your request. Please submit this request at least two weeks prior to desire event date. Our Diversity Peer Educators are trained to facilitate and tailor diversity workshops based on the need of your participants.

* Today's Date:

* Please click on the day of the week you are interested in:

* Anticipated number of participants:

* Sponsoring Organization:

* Contact Person:

* Phone:

* Email:

* Brief description of the activity or event you are interested in being provided:

* Total number of activity/events you are interested in being provided:

* The earliest available date for activity:

* The latest available date for activity:

* The length of time for programming request:

* Time of event:

* Do you currently have a room scheduled?:

Click each activity requesting:
Ability Status
Race Ethnicity
Socioeconomic Status

* What are your primary goals for the diversity initiatives? Please explain: