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Speaking request for the Vice Chancellor of Diversity
Nebraska
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Diversity Education Request
Diversity Education Request
Requestor
Name
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Contact Number
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Name of department, office, organization or group
About the Experience
Topic(s) request
Anticipated # of attendees
Intended audience (specify % of students, faculty, staff, community members, etc.)
Preferred date(s) and time of day
Preferred time frame for experience
Other Information
Expected outcomes of the experience
Frequency of experience (select one)
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Is this the first diversity education experience for your organization or department? (select one)
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General comments and other information you wish to share
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