Office of Multicultural Affairs

Diversity Program Request Form

Thank you for your interest in utilizing the Office of Multicultural Affairs 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 to fill your request. Please submit this request at least two weeks prior to desired event date.

*Indicates required field

Today's Date:
*Sponsoring Organization (represents who is legally responsible for this proposed event):
 
*Contact Person (legally responsible for event):
 
*Mailing Address:

*Day Phone:   Cell Phone:   Fax:
*E-mail:

Please provide as much information as possible. If you have questions, call 419.372.2642.

*Brief description of the activity or event you are planning:

*Total number of activity/event dates you are requesting:  


If you are requesting a RANGE of dates, with no specific date requirement, please complete this section. If you are requesting SPECIFIC dates, proceed to the next section and complete the ACTIVITY/EVENT REQUEST details.

Please click on the days of the week you are interested in:

      Mon Tue Wed Thu Fri Sat Sun

The earliest available date for activity:
The latest available date for activity  :
The length of time for programming request: hours


If requesting SPECIFIC date(s), please complete this section. 


Activity/Event Request #1

Day/Date:

Time(s) desired:

The length of time for programming request: hours


*Anticipated number of BGSU student participants (do not include spectators):
*Anticipated number of non-BGSU participants (do not include spectators):



*Check each activity requesting requested

 Personal Stereotyping 

A Visit to the Planet Earth

 Childhood Messages

Poster Activity

 Cultural Bingo

Elements of Personhood

Barnga

Read-A-Rounds

The Card Party

LGBT programming

Other Activity (please specify):

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

*What other initiatives are you seeking to understand and appreciate diversity on campus and/or in the community? Please explain:

Any additional information? Please provide special set up needs, additional date explanations or any other pertinent information.



After you submit your request, do not forget to print out the "Form Submitted" page, which should appear after you submit your request. This will serve as a confirmation that your form was submitted. If you have any questions, call 419-372-2642.


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