Creighton University : IDEA Accreditation Form

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IDEA Accreditation Form

Creighton University > Students > About Student Life > Committees > Diversity Action Team > IDEA > IDEA Accreditation Form

* denotes required field

Contact Person Information

Prefix:

First Name:

Last Name:

Department/Organization Name:

Primary Phone:

Preferred E-mail:

Program Information

Program Title:

Anticipated Program Date:

Program Start Time:

Program End Time:

Number of Attendees:

Location of Program:

Speaker Name:

Must participants register?:

Yes

Should participants register to you?:

Yes

Is there a fee?:

Yes

Program Abstract:

Description of Program:

Competencies (Please describe how the program specifically addresses one or more of the competencies):

Acknowledgement of Acceptance

By submitting this form I understand that if the program is accepted for IDEA accreditation, I will be responsible for taking attendance and submitting a copy of attendance to Aaron Mayernik (Harper 3060) within one week after the event.

I accept:

Yes

Additional Comments or Concerns:

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