The Office of Respect-Training or Program Request Form

Thank you for contacting the Office of Respect to request a workshop and/or training opportunity! Please answer the preliminary questions below and an Office of Respect representative will coordinate with you based on your request. Please note that all requests should be made at least 2 weeks in advance of your desired program in order to be approved (*you will be asked to provide two date options).

Contact Name
Organizations Name
Email Address
Phone Number
Proposed Date #1 Proposed Date #1 / MM / DD YYYY
Proposed Time #1 Proposed Time #1 : HH MM AM/PM
Proposed Date #2 Proposed Date #2 / MM / DD YYYY
Proposed Time #2 Proposed Time #2 : HH MM AM/PM
Types of Presentation:

Types of Presentation: Virtual-Live (via Zoom) & Q & A Q & A Only Pre-recorded (upload to canvas or similar platform) In-Person Other Other
Purpose for the Training Request:

Purpose for the Training Request: Graduate Orientation Undergraduate Orientation Student Organization Workshop or Training Panel Discussion Residence Life Staff Training Attend Event/Represent Office Other Other
Identify the Participants:

Identify the Participants: Undergraduate Students Graduate Students International Students Faculty Staff Entire Emory Community Select All That Apply Other Other
Training/Workshop Topic and Description:

Training/Workshop Topic and Description: Supporting Survivors Active Bystander Skills Training-Student Lead Training Sexual Harassment Training Healthy/Unhealthy Relationships (i.e. Consent, Bystander Intervention, Dating violence) Other Other
Please provide a description of your request (i.e. Desired Learning Outcomes of your training/workshop request)
How much time is allotted for the presentation and/or how much time are you requesting?
How many participants are expected?
Venue and Logistics: What equipment does the location include?

Venue and Logistics: What equipment does the location include? Zoom Virtual Set up Laptop/Computer A/V Equipment Whiteboard Chalkboard No Equipment Available Other Other
Please provide any additional Learning Considerations or ways to tailor your request to Meet the Audience Needs