Bystander Intervention Program Request Form

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Developed at the University of Arizona, the goals of Step UP! are to:

1. Raise awareness of helping behaviors
2. Increase motivation to help
3. Develop skills and confidence when responding to problems or concerns
4. Ensure the safety and well-being of self and others

Please allow a two week turnaround for scheduling. It is the responsibility of the person requesting the training to secure the space.

Email *

Name *

Email *

Phone *

Department/Club/Organization/Group *

Number of participants (or best estimate) *

Location of training *

Date requested *

YYYY

Do you prefer your facilitator to be: *

Student

Staff

Both

Either

Required

Send me a copy of my responses.

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