Personal Power Pre-Workshop Questionnaire

Please answer the questionnaire as completely and honestly as possible. Your responses are important to help us provide a successful workshop.

CONTACT INFORMATION

What best describes you?

School or Organization

Your Email(Required)

Workshop Date

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?

Are students able to identify personal and organizational values and recognize actions congruent or incongruent with them?

Do students have supportive and collaborative relationships with fellow students?

Are students aware of why this workshop is being held? Will they identify specific issues or instances of bystander behavior?

What resources are there on campus for students to utilize when addressing problematic behaviors?

Typical topics that are addressed during this workshop are hazing, bullying, drug and alcohol abuse, sexual assault, eating disorders and discrimination. What topics are relevant for your campus? Is there anything that you would like to add?

Will there be any faculty or staff in attendance?

Additional questions, comments or concerns:

Pre-Workshop Questionnaire: Personal Power

CONTACT INFORMATION

CAMPUS CLIMATE