Co-Curricular Programming Request Form Name (first and last) Course, Department, and/or Organization Program Description and Purpose Please provide a biography of the speaker. Program Date(s) Requested Program Time(s) Requested Location(s) Requested If you need a room reservation outside the HUB Cultural Center please check room availability on the 25 Live website, and complete the reservation using the University RUFAS. Funding Amount Requested Co-Curricular Learning Outcomes Please select all that apply. Explore aspects of identity, culture, privilege, and bias. Analyze “diverse” dimensions of diversity, including but not limited to ability, age, ethnicity, gender identity, race, religion /spiritual traditions, sexual orientation, and socioeconomic class. Develop empathy and concern about the impact of social injustice issues on society. Practice skills of inclusive leadership, valuing and involving all members of the group for their unique contributions. Collaborate effectively with diverse groups and make a positive difference on our campus and in the community. Meeting Days: Please select which day(s) of the week you are available for a 30 minute meeting. Monday Tuesday Wednesday Thursday Friday Meeting Times: Please list the times of the week that you are available for a 30 minute meeting. CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
