SUSTAINED DIALOGUE APPLICATION

Applicant Information 

Name	
	
Title 	
	
Department 	

		
Email	

Affiliation 	

O   Undergraduate Student
O   Graduate Student
O   Professional Student
O   Faculty Member
O   Staff Member
O   Alumni
O   Other

Application Questionnaire (Please keep your responses brief)

In your opinion, why is increased dialogue among individuals of different backgrounds and cultures important for the CWRU campus community?

What unique qualities, characteristics or skills would you bring to the dialogue group?

How do you identify yourself (your response could include information about your social identities, upbringing, beliefs or anything else that you feel is relevant to your identity)?

Discuss any past experiences and/or involvement you have had related to diversity, inclusion or social justice. (Please note: prior experience is not required to participate in the program). 

What topics related to diversity/inclusion and social justice are you most interested in discussing with others and why?

List activities and/or groups you are currently involved and list any leadership positions you
hold. (Involvement in campus and other groups is not required.)

Complete application and forward to janetta.hammock@case.edu or john.killings@case.edu