Spring 2015 Adult Diversity Dialogue Application Form


Please correct the field(s) marked in red below:

The Tempe Diversity Office is accepting applications for the 2015 Fall Diversity Dialogue Program.  The program runs for seven consecutive Monday evenings from 6-7:45 p.m. in the lower level of the Tempe Public Library.  The dates are as follows:

September 14, 21, 28
No program on October 5 due to Fall Break
October 12, 19, 26 
 November 2

Pizza will be served at 5:30 each week.  The program begins promptly at 6 p.m.

This information is required.

The following optional information will help us make the groups diverse and facilitate conversation.  Information will be kept confidential

What is your sexual orientation?

Do you have a disability?
What is your disability (optional)?
What do you hope to gain from your participation?
Signature (by typing your name you are verifying your application to the Diversity Dialogue Program):
  1. To receive a copy of your submission, please fill out your email address below and submit.
    Change the CAPTCHA codeSpeak the CAPTCHA code