Class/Event Information
Name of Instructor/Requester:
Email:
Name of Course/Club/Event:
Requested Date: Time of Course/Event:
Location: Course Number:
Amount of Time Allotted:
Number of Expected Participants:
Technology Available
Overhead Projector Whiteboard Computer
Training Requested
Please choose any topics you would like to have presented. If more than one topic
is chosen, the facilitators will choose the presentation.
Topics:
Mentors in Violence Prevention (Bystander Intervention): Sexual Assault
Mentors in Violence Prevention (Bystander Intervention): Dating Violence/
Domestic Violence
Mentors in Violence Prevention (Bystander Intervention): Harassment/Bullying
Mentors in Violence Prevention (Bystander Intervention): Stalking
Healthy Relationships: Communication, Boundaries, Etc.
SafeZone: Gender, Sexuality, and LGBTQ Identities & Issues
Trainings are designed to be interactive and are approximately one hour long.
The presentations can be modied to meet your needs. If you have any specic
requests, please make a note below.
Additional Requests/Information:
Please e-mail request form and class roster/list of anticipated attendees to
kelli.larson@indianhills.edu
Don’t Cancel Class
Training Request Form
8/17
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