Welcome To The OMA

Human Relations & Diversity Training
Registration Form


1.Choose a Date

   
Friday October 17, 2014              8:30 AM - 12:30 PM          BOCA CAMPUS
Friday November 14, 2014         12:30 PM - 4:30 PM            BOCA CAMPUS
Friday January 23, 2015              8:30 AM - 12:30 PM          BOCA CAMPUS
Friday February 20, 2015            12:30 PM - 4:30 PM          BOCA CAMPUS
Friday March 27, 2015                 8:30 AM - 12:30 PM         JUPITER CAMPUS
Friday April 10, 2015                    8:30 AM - 12:30 PM         BOCA CAMPUS

 


2.Complete the following information:

Print Name:


Z Number:


Academic College:


Major:


 

Are you currently enrolled this semester?

Yes              No  

 

The Campus where I primarily attend my classes is:

Boca
Davie
Jupiter

 

FAU E-mail:

 

Local Mailing Address:

 

Daytime Phone:

 

Evening/Alt. Phone:

 

Ethnicity:

 

Age/Age Group:

 

Gender:

 

Marital Status:

 

Disability:

 

Faith/Religion:

Other background /self-identification information you would like to share:


  3.Verify and agree to the following:

Enrollment Policy: I am a currently enrolled FAU student, and agree to attend the entire training session from 8:30 a.m. to 12:30 p.m. or 12:30 p.m. to 4:30 p.m. I understand enrollment is limited to 25 students per session and is made on a first-come, first-served basis.

Cancellation Policy: I understand that cancellations must be made in writing and faxed or postmarked at least three business days prior to the training.

Signed:

Date:

 





FAU Campuses: Boca Raton/Davie/Dania Beach/Fort Lauderdale/Jupiter/Treasure Coast Boca Raton Campus Danie Beach Campus Davie Campus Fort Lauderdale Campus Harbor Branch Campus Jupiter Campus Treasure Campus
 Last Modified 10/28/14