Workshop Registration Form

To all EOI Participants:

Please select from the required and elective courses below to complete your EOI Individual Plan. Remember that you must select workshops for all 3 required courses and at least 7 electives. If you have questions, please contact Beverly Jones Williams at beverly_williams@ncsu.edu, or call 919-513-3836.

If you are not an EOI participant but would like to register for a course offered by the Office for Institutional Equity & Diversity, please go to the Workshop Registration Form. Thank you!
Complete this form only after you have completed your EOI Application and attended EOI Orientation.
As new courses are added, you may submit this form additional times to register for additional courses. When submitting the form additional times, you do not need to re-select the courses for which you have already registered. You also do not need to resubmit your goal.
If you cannot attend a course for which you registered, please email or notify Seprina Justice at seprina_justice@ncsu.edu or 919-515-7258 as soon as possible. Thank you!

Participant Information
First Name:
Last Name:
ID Type (If you are affiliated with NC State University, please use NC State ID Number):
ID Number:
CEU Number or Birthdate (to receive Continuing Education Credits, please enter in MMDDYYYY format):
Accommodations for individuals with disabilities: Individuals with disabilities desiring accommodations to participate in these activities, please contact our office at least two weeks prior to each workshop. NCSU takes seriously its obligation to accommodate the known disabilities of its faculty, staff, students, and guests. Our goal is to make the campus a place where all can participate in a barrier-free environment.
Required Courses You must attend one of each of the following 3 required workshops.
Americans with Disabilities Act (ADA)	Fri, 10/12/2012 (1:30p.m.-3:30p.m.), Administrative Services Building III, Room 124 Tue, 03/12/2013 (1:00p.m.-3:00p.m.), Administrative Services Building II, Room 101 I have already taken this workshop. Please remove me from this workshop.
Discrimination and Harassment Prevention and Response	Fri, 10/12/2012 (10:30 a.m. -12:30 p.m.), Administrative Services Building III, Room 124 Tue, 02/05/2013 (10:00 a.m. -12:00 p.m.), Administrative Services Building II, Room 101 I have already taken this workshop. Please remove me from this workshop.
Equal Employment Opportunity and Affirmative Action	Fri, 10/12/2012 (8:15 a.m. - 10:15 p.m.), Administrative Services Building III, Room 124 Thu, 02/21/2013 (10:00 a.m. - 12:00 p.m.), Administrative Services Building II, Room 101 I have already taken this workshop. Please remove me from this workshop.
Equal Employment Opportunity Institute (EEOI) (This course is intended for employees and can substitute for the previous 3 required courses plus 1 elective. Preference is given to Managers and Supervisors.)	Please see current offerings eLearning. I have already taken this workshop. I plan to take this workshop and will register in the NC State eLearning system. Please remove me from this workshop.
Elective Courses You must attend a minimum of 7 of the following elective workshops. Note: An asterisk () indicates that you can receive LDS credit for attending the workshop.*
Please note: Workshop registration is monitored five (5) working days before each class. Each class must have a minimum of 10 participants; classes that do not meet the minimum are subject to cancellation.
Affirmative Action in Employment	Wed, 03/28/2013 (10:00 a.m. -12:00 p.m.), Administrative Services II, Room 212 Please remove me from this workshop.
The EEOC (Equal Opportunity Employment Commission)	Wed, 10/17/2012 (2:00 - 4:00 p.m.), Administrative Services Building II, Room 101 Please remove me from this workshop.
Equal Opportunity Jeopardy	Thu, 04/11/2013 (1:00 p.m. - 3:00 p.m.), Administrative Services Building II, Room 101 Please remove me from this workshop.
Exploring Oppression	Wed, 11/28/2012 (1:00 - 3:00 p.m.), Administrative Services Building II, Room 101 Please remove me from this workshop.
Fair Housing	Tue, 01/29/2013 (10:00 a.m. - 12:00 p.m.), Avent Ferry Complex, Room 106 Please remove me from this workshop.
Generations at Work	Wed, 10/03/2012 (1:30p.m.-4:30p.m.), Administrative Services II, Room 212 Thu, 04/04/2013 (9:00 a.m. - 12:00 p.m.), Administrative Services II, Room 212 Please remove me from this workshop.
Leading a Diverse Workforce	Wed, 11/14/2012 (10:00 a.m. - 12:00 p.m.), Administrative Services Building III, Room 124 Please remove me from this workshop.
Legacies + Layers = Lenses (Campus Diversity Conflicts: Methods for Managing the Unmanageable)	Tue, 03/19/2013 (1:00p.m.-3:00p.m.), Administrative Services Building II, Room 101 Please remove me from this workshop.
Project Safe	Fri, 09/14/2012 (9:00 a.m. - 12:00 p.m.), Harrelson Hall, Room 330 Tue, 10/16/2012 (1:00-4:00 p.m.), Harrelson Hall, Room 330 Fri, 11/16/2012 (9:00 a.m. - 12:00 p.m.), Harrelson Hall, Room 330 Tue, 02/05/2013 (9:00 a.m. - 12:00 p.m.), Harrelson Hall, Room 330 Fri, 03/15/2013 (1:00 - 4:00 p.m.), Harrelson Hall, Room 330 Thu, 04/11/2013 (9:00 a.m. - 12:00 p.m.), Harrelson Hall, Room 330 Please remove me from this workshop.
The Protected Class of Age	Thu, 03/28/2013 (1:00 - 3:00 p.m.), Administrative Services Building II, Room 101 Please remove me from this workshop.
The Protected Class of Disability	Thu, 02/07/2013 (1:00 - 3:00 p.m.), Administrative Services Building II, Room 101 Please remove me from this workshop.
The Protected Class of National Origin	Wed, 02/13/2013 (10:00 a.m. - 12:00 p.m.), Administrative Services Building II, Room 101 Please remove me from this workshop.
The Protected Classes of Race and Color	Tue, 10/23/2012 (1:00 - 3:00 p.m.), Administrative Services II, Room 212 Please remove me from this workshop.
The Protected Classes of Religion and Creed	Wed, 02/13/2013 (1:00 - 3:00 p.m.), Avent Ferry Complex, Room 106 Please remove me from this workshop.
The Protected Class of Sex	Tue, 10/23/2012 (10:00 a.m. - 12:00 p.m.), Administrative Services Building II, Room 101 Please remove me from this workshop.
The Protected Class of Veteran Status	Wed, 11/07/2012 (10:00 a.m. - 12:00 p.m.), Avent Ferry Complex, Room 106 Please remove me from this workshop.
Special Topics for Managers & Supervisors	Wed, 04/03/2013 (10:00 a.m. - 12:00 p.m.), Administrative Services Building II, Room 101 Please remove me from this workshop.
Transgender 101	Wed, 10/17/2012 (9:00 a.m. - 11:00 a.m.), Harrelson Hall, Room 330 Tue, 11/13/2012 (1:00 p.m. - 3:00 p.m.), Harrelson Hall, Room 330 Wed, 04/10/2013 (1:00p.m.-3:00p.m.), Harrelson Hall, Room 330 Please remove me from this workshop.
Title IX: Gender Equity in Higher Education	Tue, 02/19/2013 (10:00 a.m. - 12:00 p.m.), Avent Ferry Complex, Room 106 Please remove me from this workshop.
Valuing Differences Through Diversity	No current offerings. Please remove me from this workshop.
Building Bridges: Strengthening Leadership for Diverse Communities: Part I (NCBI) (For additional NCBI workshops, see the NC State NCBI website.)	Tue, 10/30/2012 (9:00 a.m. - 12:00 p.m.), Winslow Hall, First Floor Conference Room Please remove me from this workshop.
Building Bridges: Strengthening Leadership for Diverse Communities: Part II (NCBI) (For additional NCBI workshops, see the NC State NCBI website.)	Thu, 11/01/2012 (9:00 a.m. - 12:00 p.m.), Winslow Hall, First Floor Conference Room Please remove me from this workshop.
Building Bridges: Strengthening Leadership for Diverse Communities: Parts I & II (NCBI) (counts as 3 electives)	Fri, 08/24/2012 (10:00 a.m. - 4:00 p.m.), Winslow Hall, First Floor Conference Room Fri, 04/05/2013 (9:00 a.m. - 4:00 p.m.), Student Health Center, Room 2301 Please remove me from this workshop.
Building Bridges: Leading Diverse Groups Through Conflict	Thu, 01/31/2013 (1:00 - 3:00 p.m.), Winslow Hall, First Floor Conference Room Please remove me from this workshop.
LDS: Building Bridges: Strengthening Leadership for Diverse Communities: Part I (NCBI)*	Thu, 10/11/2012 (6:30PM- 8:30PM), Talley Student Center, Room 3118 Tue, 03/12/2013 (6:30PM- 8:30PM), Talley Student Center, Room 3118 Please remove me from this workshop.
LDS: Building Bridges: Strengthening Leadership for Diverse Communities: Part II (NCBI)*	Wed, 10/17/2012 (6:30PM- 8:30PM), Talley Student Center, Room 3118 Please remove me from this workshop.
LDS: Building Bridges: Leading Diverse Groups Through Conflict (NCBI)*	Tue, 11/06/2012 (6:30PM- 8:30PM), Talley Student Center, Room 3118 Tue, 03/19/2013 (6:30PM- 8:30PM), Talley Student Center, Room 3118 Please remove me from this workshop.
LDS: Cross Cultural Communication*	Mon, 10/08/2012 (6:30PM- 8:30PM), Talley Student Center, Room 3118 Please remove me from this workshop.
LDS: GLBT 101*	Tue, 02/19/2013 (6:30p.m. - 8:30p.m.), Talley Student Center, Room 3118 Please remove me from this workshop.
LDS: Leadership & Social Justice*	Wed, 11/14/2012 (6:30PM- 8:30PM), Talley Student Center, Room 3118 Wed, 03/13/2013 (6:30PM- 8:30PM), Talley Student Center, Room 3118 Please remove me from this workshop.
LDS: Leadership Tools for Women*	Wed, 09/19/2012 (6:30PM- 8:30PM), Talley Student Center, Room 3118 Please remove me from this workshop.
LDS: Project Safe*	Mon, 10/22/2012 (6:30p.m. - 8:30p.m.), Talley Student Center, Room 3118 Please remove me from this workshop.
LDS: Working with Diverse Populations*	Thu, 10/25/2012 (6:30PM- 8:30PM), Talley Student Center, Room 3118 Thu, 02/28/2013 (6:30PM- 8:30PM), Talley Student Center, Room 3118 Please remove me from this workshop.
Optional Events We look forward to seeing you at these complimentary events for EOI participants.
EOI Mid-Year Reflection Lunch	Wed, 01/23/2013 (11:30a.m.-1:00p.m.), Student Health Center, Room 2301
EOI Graduation	Tue, 04/30/2013 (10:00 a.m. - 12:00 p.m.), Hunt Library, Institute for Emerging Issues (IEI) Multipurpose Room
Program Goals
Please provide a brief statement of the personal goals that you hope to achieve by attending the Equal Opportunity Institute. (Note: You do not need to resubmit your goal if you have already submitted it.) I am submitting an updated goal.
Special Needs or Concerns
Please provide information about any special needs, circumstances, or concerns that you may have.
Comments
Please provide any notes or comments on your registration or registration updates.
Submit Your Plan
By submitting this plan, you agree to complete the workshops that you have selected to graduate from the Equal Opportunity Institute (EOI). Note: NCSU Employees must ensure that your supervisors review and approve your course plan.