Facilitators Skills Training

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					           Because it’s time for a change.                                           TEAM.LIBERATION@OREGONSTATE.EDU
                                                                                             Offices ~ 245 Snell Hall
                                                                                   Mailing Address ~ 149 Memorial Union East
                                                                                              Corvallis, OR 97331
                                                                                                   Phone: 541/737-9857
                                                                            HTTP://OREGONSTATE.EDU/GROUPS/TEAMLIBERATION/


FACILITATOR SKILLS TRAINING                                                                  APPLICATIONS DUE: May 29th
PARTICIPANT APPLICATION
                             2009 Spring Training: June 16-19, 9am–5pm each day

Name:                                                                                  Home/Cell Phone #:


Address:

                                                                                       County:


OSU ID #:                                                                              E-Mail:


Applicant Signature:                                                                                     Date:

The following demographic information is optional but helpful for those planning training:


Gender:                                                            Language(s) Spoken:


Sexual Orientation:                                                Religious/Spiritual Background:


Nationality:                                                       Disabilities:


Racial/Ethnic/Cultural Background: __________________


Dietary Preferences/Restrictions:

Please be aware that attendance at all four days of the training session is mandatory. Exceptions will be made
only in the case of an emergency.

Drop-off this application                       Mail this application                  Email this application
Student Leadership & Involvement                Team Liberation                        team.liberation@oregonstate.edu
Information Desk                                149 Snell Hall/Memorial Union East
149 Snell Hall/Memorial Union East              Oregon State University
Corvallis, OR 97331                             Corvallis, OR 97331


           For accommodations related to a disability, please contact us by May 29th, 2009.
                                     Be sure to answer the questions on page 2 of this form.




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PL EA SE         AN S W ER         T HE      FO LL O WI N G           Q U ES TIO N S :

1.   Why do you want to participate in the Team Liberation facilitator training?




2. Describe your past experience with diversity programs and social justice activities/education.




3. What is your background with facilitating discussions, and/or your experience with community development?




4. Please describe your experience in working with diverse groups of people.




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