Application for the Pluralism and Unity Program

First name

Last name

Hometown (City/State/Country)

Gender

E-mail Address

T-shirt Size

Allergies/Dietary Restrictions

Please respond to the following 4 questions. You may find it helpful to compose your response in a word processor/editor and then paste the response into the appropriate area on this form.

1. Describe your racial, ethnic, and cultural identities. What do your racial and ethnic identities mean to you, and how did you come to that understanding?

2. What country did you grow up in? How have your racial and ethnic identities been impacted by your country of origin?

3. What is your previous experience, if any, with issues related to race/racism, intercultural relations, and/or multiculturalism?

4. Explain your reasons for wanting to be a part of the Pluralism & Unity Program. What would you like to learn about yourself and others? Why do you think it is important to explore issues of race, identity, and multiculturalism in a diverse group of your peers?

** I understand that participation in this program will require me to attend fall and spring semester retreats, large group workshops on campus one Thursday a month from 4:30pm - 7:00pm, and small group meetings one day a month from 4:30pm - 5:30pm. I will commit to attending these meetings, and if a conflict exists for me with attending these meetings, I am aware that I may be ineligible to participate in the program. My initials below indicate I have read and understand this program requirement.

Initials