Straight Facts Workshop Request Form

Name Name First Last
Contact Email
Phone Phone - ### - ### ####

*Please include a number that can be used on the date of the program
Requested Date Requested Date / MM / DD YYYY

*Programs must be requested at least 7 days prior to implementation and are subject to availability
Time of Program
Length of Program

*Programs usually are received best at 1 hour
Collaborative Partners

*Leave blank if N/A
In-person or Zoom program?

In-person or Zoom program? In-person Zoom
Zoom
Building and room number
Technology Available

Technology Available LCD Projector/Laptop Whiteboard Flip Chart Microphone
Checkboxes

Checkboxes Creating a Common Language How to create Trans Inclusive Communities Social Justice Ally Development- Moving Beyond Tolerance LGBTQI Life Resources on Campus & beyond Create your own with LGBTQI Life staff person
What major point do you want participants to walk away with?
Is there anything else you would like to address with this program that you have not indicated above?