Dolphin Allies Advance Workshop Registration
Interested parties can submit their requests to attend a Dolphin Allies Advance Workshop by completing the form below. The information on this form will be sent to the Advance Coordinators. You will receive a confirmation (usually through email) for the date and time of your scheduled workshop.
Registration for each Advance is limited to a maximum of 15 participants. Registration requests should be submitted at least 48 hours in advance of the preferred workshop date to allow time for the Advance Coordinators to confirm your registration.
First Name:
*
Last Name:
*
E-mail:
*
Phone:
What is your primary status at JU?
Faculty
Staff
Student
Community Member
Please rank your preferred workshop dates.
First Choice
*
Please Select
Wednesday, November 17th, 1:00pm - 2:15pm
Friday, December 3rd, 2:00pm - 3:15pm
Second Choice
*
Please Select
Wednesday, November 17th, 1:00pm - 2:15pm
Friday, December 3rd, 2:00pm - 3:15pm
None of these dates
What is your gender?
Male
Female
Transgender
How did you hear about Dolphin Allies or the Advance Workshop?
Allies Web Page
Navigator Advertisement
Flyer/Poster
Letter/Mailing
Resource Table
A Current Ally
Residential Life staff member
How would you rate your current knowledge level about LGBT issues?
*
Minimal
Average
Proficient
How would you rate your current comfort level in talking about LGBT issues?
*
Very Uncomfortable
Uncomfortable
Comfortable
Very Comfortable
Why are you interested in becoming an Ally and what do you hope to get out of the Workshop?
*
Please indicate here if you have any special accommodation requests or needs for the workshop.
Submit
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