Office for Equity & Diversity Consultation/Facilitation Request Form
This form helps our office best gauge your needs and determine who is best suited to provide consultation/facilitation.

Please note that we can not ensure confidentiality with this form. As such, please do not include sensitive departmental or personnel information in your responses.

If you have any questions, please contact
Email address *
Name of Institution/Department/Unit *
Contact Name *
Contact Email *
Contact Phone *
Please provide the date(s) and time(s) for the event(s) for which you are requesting consultation/facilitation: *
Tell us about the topic of the meeting, discussion, town hall, conversation circle, etc. for which you are requesting consultation/facilitation: *
Is there anything else you would like to share regarding the type of consultation, support, or resources you're requesting:
Size of Unit/Department *
Target Audience *
What other equity and diversity work is your unit/department participating in currently or in the past? *
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