Faculty/Instructor Dialogue Request FormIf you don't have all of the information to complete this form, please contact us to finish your request: pilar.prostko@colorado.eduPlease allow 3-4 weeks to prepare for dialogue after request is submitted.You must have JavaScript enabled to use this form.Indicates required field Your Name:Your Email: Your Phone Number: School/CollegeCampus Department/UnitDepartment or Unit Program Assistant/CoordinatorDepartment or Unit Program Assistant/Coordinator PhoneCourse Number and Name (e.g. Hist 1015: US History to 1885) or Event Title:DateTimeBuilding & Room Number:Expected Attendance:Reasons for dialogue request: (mark all that apply) To create a memorable learning experience for students To extend student learning about a particular course topic/concept To present students with perspectives on a topic that they would not otherwise hear To address a controversial topic or complex issue that cannot easily be addressed through regular class discussion To learn about dialogue as a pedagogical tool to use in my own teachingWhat topic(s) would you like to address in the dialogue?What are some specific questions you would like to address in the dialogue?List your key learning goals (outcomes) for hosting a dialogue in your course. Please explain how and to what extent they align with course goals.Would you like assistance in creating follow-up materials to use in your class after the dialogue? No YesWould you like any other form of assistance or to meet with the CU Dialogues Program Coordinator/Facilitator before setting up a dialogue?
