2020 ASU Symposium on Sexual Violence in Higher Education Registration Form

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Join students, faculty, and staff from colleges and universities across the state in a learning experience designed to strengthen sexual violence prevention efforts across campuses. In accordance with this year’s theme, Creating Community, Making Waves, presentation topics will include the intersection between sexual and relationship violence, trauma-informed support for victims/survivors, and community-wide action.

January 24th, 2020
9am - 5pm, ASU Tempe Campus
Questions about the event can be sent to consent@asu.edu.

Registration is currently limited to students, staff, and faculty from Arizona colleges and universities; and members from pre-approved community organizations.

Full Name *

Email *

I am attending as a(n): *

Undergraduate Student

Graduate Student

Staff

Faculty

Community Organization Member

Affiliated University or Community Organization *

How did you hear about the Symposium? *

Social media

Promotional email

AZIHE Network

Arizona Department of Health Services

Academic College Mailing List

Student Organization Mailing List

Professor

University Staff (Other than professor)

ASU App Push Notification

Other:

Please select which option applies to you regarding your travel to ASU Tempe *

I am an employee or student who predominantly attends ASU Tempe.

I am an employee or student who predominately attends another ASU location.

I work outside of ASU and will drive myself.

I work outside of ASU and will carpool with others who are attending the symposium.

In order to maximize the experience for our attendees, we ask that those who register stay for the entire symposium. Are you able to attend for the full day? *

Students who need to leave for class will be given an exception

Yes

Dietary Restrictions for Lunch *

Vegetarian

Vegan

Gluten-free

None

Other:

Would you like to request any of the following accommodations? (If so, a symposium coordinator will reach out to you prior to the event to ensure your specific needs are accommodated.) *

Hearing

Visual

Mobility

None

Other:

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