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Specialized Training & Presentation Request Form
Specialized Training and Presentation Request Form
Overview: LGBTQ+ Resources is committed to providing a safe and inclusive campus climate for students. To further support this mission and the needs of students, our office provides an array of services and programming concerning LGBTQ-related topics. If you are interested in scheduling a session, please complete the request form below. We welcome requests from individuals, groups, residential student organizations, departments, classes, etc. Please note that requested time slots are allocated for a maximum of 1 hour, unless otherwise requested/ or it's for a Safe Zone Program Module. Request Requirements: Must submit request at least 3 weeks prior to intended date of event. Please provide the following information:
Requestor's Name:
*
Mason Affiliation:
*
(i.e., student, professor, RSO)
Email:
*
First Prospective Date Desired for Request
*
Date Format: MM slash DD slash YYYY
Remember, requests must be made at least 3 weeks prior to desired date.
Second Prospective Date Desired for Request
*
Date Format: MM slash DD slash YYYY
Third Prospective Date Desired for Request
*
Date Format: MM slash DD slash YYYY
First Prospective Time Slot Desired for Request
*
:
HH
MM
AM
PM
Remember, requested time slots are allocated for a maximum of 1 hour, unless otherwise requested/ or it's for a Safe Zone Training Module.
Second Prospective Time Slot Desired for Request
*
:
HH
MM
AM
PM
Third Prospective Time Slot Desired for Request
*
:
HH
MM
AM
PM
Request Rationale:
*
Please share your reason for making this request.
Type of Request:
*
Info About Our Office & Programs
Intro to LGBTQ
Pronouns
Interviews and/or Research
Personal Meeting
Other (Please describe in "Additional Information" box)
Please note that each approved request will be scheduled for a maximum of one hour, unless otherwise requested/ or it's for a Safe Zone Training Module.
Safe Zone Modules
Awareness Module
Gender Module
Ally & Skills Building Module
Specialized Module (please explain in "Additional Information" box)
Individual and specialized modules available per request. Note that each Safe Zone module is typically allotted for 2.5-3 hours.
Number of Expected Attendees:
*
Additional Information:
*
Is there anything else we need to know concerning your request? In so, please describe below. If not, type "N/A" below.
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