Safe Zone Ally Training   GLBTQ Workshop

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Contact name:

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Contact phone number:

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Organization:

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Contact E-Mail (required):

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Workshop date/time(s):

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Length of workshop:

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Location of workshop:

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Participant information

Number of participants expected:

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Age (Range):

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Gender (#) expected: F: M: T:

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Positions/roles in group:

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Ethnic/Racial backgrounds (#):

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Participant relationships (how well do participants know each other?):

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What process or goals do you wish to accomplish with this training or workshop?

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What might pose challenges for the participants to engage with comfort or honesty?

What will you do to ensure that the process starts in a way that provides "safety" with respect to the hospitality, physical and psychological needs of the participants?

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How will you prepare your group for this workshop/training and what follow-up will you do on the facilitations?

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What other information would you like to provide the Safe Zone trainers? (Specific requests, needs, etc.)

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Possible Safe Zone Training Options - do you have requests for activities or training modules that you are familiar with? If so, please indicate that below:

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If your on-campus presentation or workshop would require accommodations for disabilities, contact the Office of Disability Services at (503) 838-8250.

This submission form is submitted via e-mail.

After clicking this submit button you may be asked to fill in your email adress, you must do so to fully submit your information. You will NOT receive an e-mail notifying of your submission once complete, but the Safe Zone will contact you shortly following your request.

If you do not hear from someone from Safe Zone within 3 business days, contact us directly at safezone@wou.edu.