Diversity Workshop Registration Slip HR

Diversity Workshop Registration Slip

This registration form is designed to collect essential information from participants like you to ensure a smooth and tailored experience during the workshop. Diversity and inclusion are crucial aspects of creating vibrant, innovative, and equitable environments in today's world.

Full Name:	[YOUR NAME]
Company Name:	[YOUR COMPANY NAME]
Email Address:	[YOUR EMAIL]
Contact Number:	[YOUR CONTACT NUMBER]
Job Position:	[YOUR JOB POSITION]

Demographic Information (Optional):

Male	Female	Non-Binary
Caucasian/White	African American/Black	Hispanic/Latinx
Asian	Indigenous/Native	Other

Please indicate which sessions you would like to attend:

Session 1:		Session 2:
Session 3:		Session 4:

Any Dietary Restrictions:	Yes No
Accessibility Needs (please specify if applicable):	Dietary Restrictions Mobility Assistance Sign Language Interpreter Other
Please indicate your reasons for attending this workshop (check all that apply):	Personal interest Professional development Organizational requirement Promoting diversity and inclusion Other: ____________________
Please list any specific expectations or goals you have for this workshop:

How did you hear about this workshop? (check all that apply):

Email
Social Media
Colleague or Friend
Company/Organization Announcement
Other: ____________________

Emergency Contact Information:

Name:
Relationship:
Phone Number:

I acknowledge that my participation in this Diversity Workshop is subject to the terms and conditions outlined by the organizers, including any workshop fees, cancellation policies, and code of conduct.

Signature:

Date: [September 26, 2050]