SHPP Training Request

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Sexual Harassment Prevention Program Training Request Form

Date Submitted
Contact Name      Email    Phone
Campus Unit    Campus Address
Dean, Director, Department Head

Audience Demographics

Academic Status (Check all that apply)
Exempt Staff
Non-Exempt Staff
Faculty
Graduate Student
Undergraduate Student

Racial Category (Please provide us with numbers)
African American/Black             Asian/Asian American/Pacific Islander
Native American                       European American/White
Latina/o                                  Arab American
International
Other (if any of the above do not apply, please fill this out).

Number of Participants

Please indicate the number of persons attending this workshop. Please provide a breakdown by gender, if possible.

Total Participants

Males Females

Workshop Date and Time

Please list three workshop dates and times in order of priority. Please note that workshops for faculty, staff, and/or graduate students takes approximatelytwo hours, while workshops for undergraduate students take approximately one hour.

1. Date:Time:
2. Date:Time:
3. Date:Time:

Location: (Please be SPECIFIC)

For what purpose(s) are you requesting this training: (Please explain)

Has the issue of sexual harassment ever been discussed with this group: (Please explain)

Has this group received a copy of the sexual harassment policy? (Please explain)

Comments:

Due to limited resources, we request that units receiving training prepare copies of the handout packet for all participants.

You may download the SHPP Training Packet here in a regular or large print format.

Your request will be submitted by email to the coordinator of the SHPP program. You will receive an email "receipt" within one working-day of submission.

Questions about the Sexual Harassment Prevention Program can be addressed by the SHPP Coordinator shpp@umd.edu.