City of Hampton, Unity Commission, Diversity College Registration

Diversity College Application

All fields marked with * are required.

Hampton Diversity College - Level II Disability Awareness...Inclusion & Access for All Tuesdays, May 15 - May 29, 2012
*First Name:	*Last Name:
Nickname:
*Address:
City:	State: Zip:
*Daytime Phone:
*E-mail:	*Gender:
Indicate why you are interested in enrolling in the Hampton Diversity College:
What do you hope to gain or learn from participating in the Hampton Diversity College?:
Describe your involvement with other community and/or civic activities:
Are you willing to make a good-faith commitment to attend ALL class session for this course?:
How did you hear about the Hampton Diversity College?: