Syracuse University
CARE Intergroup Dialogue Interest Form

RESIDENCE HALLS

Fall 2008
       
Thank you for your interest in intergroup dialogue! CARE dialogues are open to both residential and non-residential students. Fall semester CARE dialogues will start around the end of September. If you are interested in participating in one of these dialogues, please complete and submit the following form. We will contact you next semester to complete registration.
       
REGISTRATION INFORMATION
       
First Name:
       
Last Name:
       
Student ID number:
       
Campus Address    
       
Email address:    
       
Cell phone:    
       
Intergroup dialogues meet for two hours each week for six weeks. Which timeframe is of interest to you?
  A weekday evening (M, T, W, or Th), 7 – 9 p.m.

Sunday, 2 – 4 p.m.

Sunday, 4 – 6 p.m.

    
       
 Have you ever participated in an intergroup dialogue? Yes No
  If yes, specify:
       
Please explain your motivation to engage in intergroup dialogue about race and ethnicity.
 
       
How did you hear about the CARE program (Check all that apply)?
  From my RA
From my Residence Director
From a Friend
From a Professor
From a Staff Member
Facebook
Email Invitation
Poster in a Residence Hall
Mailbox Stuffer
I'm an RA
Other