Office of Multicultural Affairs

Diversity Peer Educators Programming 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 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.

*Indicates required field

*Today's Date:

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

Monday Tuesday Wednesday Thursday Friday Saturday Sunday

* Anticipated number of BGSU participants:

* Sponsoring Organization:

* Contact Person:

* Phone:

* E-mail:

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

*Total number of activity/events dates 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: hours

* Time of event:AM PM

* Do you currently have a room scheduled YES NO

* Click each activity requesting

Ability Status

Culture

Difference

Gender

LGBT

Oppression

Race Ethnicity

Religion

Socioeconomic Status

Stereotypes

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

Questions?

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.