Wufoo
CCDP Registration Form
The Intercultural Center is thrilled to launch a new initiative this spring! The Critical Conversations Dialogue Program is an opportunity for individuals from multiple backgrounds and identities at UMB to come together and engage in dialogue on topics related to social identity.
CCDP is a 4-week cohort-based dialogue program facilitated by 2 trained facilitators. Each dialogue session is 2 hours long and is limited to 15 participants. The topic for the spring is race and racism. Please note that the Student Dialogue is only for students and the Staff and Faculty Dialogue is only for staff and faculty. To register for these dialogues, please complete the following information.
Student Dialogue
Dates: Thursdays 02/17, 02/24, 03/3, 03/10
Time: 12:00 - 2:00 PM
Staff and Faculty Dialogue
Dates: Mondays 02/14, 02/21, 02/28, 03/7
Time: 12:00 - 2:00 PM
Name
*
First
Last
Email
*
University Affiliation
*
...
Francis King Carey School of Law
School of Social Work
School of Nursing
School of Medicine
School of Dentistry
School of Pharmacy
Graduate School
General Administration
Please select which dialogue you would like to register for:
*
Student Dialogue
Staff and Faculty Dialogue
Are you able to commit to all 4 dialogue sessions?
*
Yes
No (Please be aware that if you cannot attend each session, you will be unable to participate in the dialogue)
Maximum of
250
characters.
Currently Used:
0
characters.
Please identify your race and/or ethnicity. Select all that apply:
*
Black or African American
Latinx/a/o or Hispanic
American Indian or Alaska Native
Native Hawaiian or Pacific Islander
Asian
White
Southwest Asian and North African - Middle Eastern
Multiracial
Other
If you require accommodations, please describe below:
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