Name:
*
Email:
*
Your Role:
*
Faculty
Staff
Undergraduate Student
Graduate Student
Other
Organization/Department/Group:
*
Group Size:
*
Small: 5-10
Medium: 11-25
Large: 26-50
Presentation: 51-100
Location:
*
On campus
Zoom
Please include the building and room number: (The requester is responsible for securing a room for this training.)
*
Preference for time of day:
*
Daytime
Nighttime (limited to staff availability)
Weekend (limited to staff availability)
Date-First Choice:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Start Time-First Choice (all workshop sessions require at least 1.5 hours):
*
Hour Minutes
AM
PM
AM/PM Option
Date-Second Choice (in case the first date is unavailable):
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Start Time-Second Choice:
*
Hour Minutes
AM
PM
AM/PM Option
Will this workshop be part of an ongoing learning series (Ex. retreat, staff meeting, exec board meeting)?
*
Yes
No
Please describe the participant population:
*
Undergraduate Students
Graduate and/or Professional Students
Community Members
Faculty/Staff
Training offerings:
*
Green Dot Bystander Intervention
RSVP Center and Resource Overview
Creating a Trauma Informed Campus
Masculinities Training
LGBTQIA+ at WashU
Boundary Setting and Group Culture
Other
Describe the primary goals and learning outcomes you wish to accomplish as a result of this training:
*
Describe the group’s experience with this topic, if any:
*
Any additional information that would be helpful for us to know:
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