Workforce Diversity

A2. Student Information Sheet

 

Name

 

 

 

Company

 

 

 

Position

 

 

Phone (Day)

 

 

 

(Eve)

 

 

Email (print clearly)

 

 

 

How will you access on-line course information (check all that apply)?

 

 Home

 School

 

 Work

 Other __________

 

Major

 

 

 

Class

 

 

Career Goals

 

 

 

 

Diversity Training and/or Experience

 

 

 

 

 

 

What are your goals for this course?

 

 

 

 

What areas of diversity are you particularly interested in?

 

 Race/Ethnicity

 Abilities/Disabilities

 Other  _________

 Class

 Religion

 Gender

 Age

 

What questions do you have regarding diversity issues that you’d like to see addressed in this course?

 

 

 

Anything else you want to tell me that would be helpful for me to know