Spring 2015 Adult Diversity Dialogue Application Form

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

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

February 23
March 2, (no program March 9 due to Spring Break),  March 16, March 23, 30
April 6, 13, 20

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):
 *
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