Training request form

Today's date (mm/dd/yy):

Requested date for presentation/program/training (mm/dd/yy):

Applicant name:

Email address:

Phone number:

Department/group:

Best way to contact?

Expected number of attendees

Is pre-registration required?

YesNo

If yes, how many are currently registered?

What methods have you used to promote this event/program?

Social media
Campus Community Connection (CCC)
Fliers/Posters
Co-sponsors
Other:

Do you plan to provide food?

YesNo

Disclaimers:

Groups requesting a program/presentation/training are responsible for securing a location.
Our office requires a minimum of 2 weeks advance notice. We are unable to provide programming on Saturdays and Sundays.
Medallion Program Requests must have at least 15 participants registered.
Programs in a Residential Hall/Special Interest House must have at least 10 participants present.

Presentation/Program/Training type requested:

Unpacking Sexual Misconduct (Medallion program)
BADASS Bystander (2.5 hour class)
Event Fair / Information Table
Title IX Refresher
Supporting Your Friends and Yourself
Sexual Misconduct Jeopardy!
Responsible Employee Training
Other

If other, please explain:

Please describe any specific situation or event that led to this request. You may also write "Refresher", "Annual", "Recognized Need", “General Interest” etc.:

Sexual Misconduct and Title IX

Training request form

Reporting options

If you have been assaulted

Helping a friend

Policies & resources

Title IX explained

Training

Please complete and submit this online form to request training, or you can print and submit the request form.