About
Our Core Values
For New Customers
Event Formats
Our Staff Team
FAQs
Apply to be a Speaker
Speakers
Workshops
Workshops
Facilitators
Consulting
On-Demand Courses
Initiatives
Speakers Academy
Speakers Blog
National Masculinity Week
Hazing Prevention Certification
Contact
About
Our Core Values
For New Customers
Event Formats
Our Staff Team
FAQs
Apply to be a Speaker
Speakers
Workshops
Workshops
Facilitators
Consulting
On-Demand Courses
Initiatives
Speakers Academy
Speakers Blog
National Masculinity Week
Hazing Prevention Certification
Contact
Pre-Workshop Questionnaire: Crossing The Line
Please answer the questionnaire as completely and honestly as possible. Your responses are important to help us provide a successful workshop.
CONTACT INFORMATION
Your Name
(Required)
First
Last
What best describes you?
Professional
Graduate Assistant
Student
School or Organization
Your Email
(Required)
Workshop Date
MM slash DD slash YYYY
Please provide a contact number for the day of the event (ideally a cell phone for someone who will be on campus)
What will the room layout be? (keep in mind the recommended room layout is round tables with PowerPoint visibility for all students)
CAMPUS CLIMATE
Please describe the reason for bringing this workshop to your campus:
What groups/organizations/students will be present? Is there anyone else you would like to include in this discussion that are unable to attend?
Please identify potential hot button issues or topics for your students:
Tell us about your campus culture/any recent issues that might come up in the discussion:
Is there anything else that the facilitators need to know about your students, campus or community before the workshop?
Will there be any faculty or staff in attendance?
The participants have had previous hazing prevention training
Agree
Disagree
I would consider the hazing in our community to be
Very Prevalent / Major Issue
Somewhat Prevalent / Somewhat of an Issue
Not Prevalent / Not an issue
Unknown
Participants are able to communicate effectively and respectfully with those who are different from them
Agree
Disagree
Participants can demonstrate the ability to engage in challenging dialogue with integrity
Agree
Disagree
Students will ask questions and actively participate
Agree
Disagree
Students will be open and honest
Agree
Disagree
This is a mandatory event for those attending
Agree
Disagree
Additional questions, comments or concerns: