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Group/Team/Club requesting facilitation:
Name of contact person:
Email address of contact person:
Number of students in the group:
How would you describe the diversity of the group (gender, class year, race, etc.):
Why are you/the group interested in having this facilitation? Was this interest prompted by any events within the group, on campus, or nationally?
Has your group had any previous conversations around race, priviledge, or diversity (formally or informally)? If so, could you describe how the conversation went?
What is your goal for this workshop? What do you want your team or group to get out of it?
Typical facilitations last about an hour. Is this alright or were you interested in a longer meeting or multiple meetings with facilitators?
Please provide several times and days of the week when your group could be available for this facilitation. Please note that we ask for two week's notice for scheduling facilitations:
Any other comments/things we should know:
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