Greendale Welcomes Diversity, October 18 & 21 at Greendale High School, MPR
Please complete the questions below. You may respond for up to two people. Be sure to indicate how many people (adults) will join us at 5:00 p.m. both days for dinner. Child care will be available for children age 3 and older who are potty trained.

If you are unable to attend, but still would like to participate in the events planned by the Coalition, please submit your name and email address and answer the statement of interest questions at the bottom of this form. Thank you!

Coalition for Diversity, Equity & Inclusion Steering Committee
Gary Kiltz, Diannia Merriett and Todd Michaels, co-chairs
Amy Ali, Nicole Brookshire, Sally Chadwick, Tom Combs, Nat Godley, Jackie Schweitzer, Kevin Svoboda, Kathleen Wied-Vincent and Erica Young
Name: *
Your answer
Email Address: *
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Phone Number:
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Name (second person):
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Email Address (second person):
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Phone Number (second person):
Your answer
Number of people attending Greendale Welcomes Diversity Dinner and Event on October 18. *
Your answer
Number of people attending Greendale Welcomes Diversity Dinner and Event on October 21. *
Your answer
I need child care on October 18. Please indicate number and ages of children.
Your answer
I need childcare on October 21. Please indicate number and ages of children.
Your answer
I am unable to attend the events on October 18 and 21 but would like to participate in future Greendale Welcomes Diversity activities.
How did you hear about this event? (Please select all that apply)
Join us October 18 & 21 in the MPR at GHS
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