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SJSU Black Leadership and Opportunity Center's Student Leader Panel Presentation Request Form
Greetings,
Thank you for your interest in learning about the Black Leadership and Opportunity Center (The BLOC) at San Jose State University. We look forward to connecting with you and your students by hosting a panel presentation with our current Black/African-American student leaders from our Center. We are eager for an opportunity to engage in dialogue with prospective Spartans who have interest in learning about the experiences of SJSU students as a Black Spartan. Due to limited staffing, we ask that you fill out this form within a
minimum of three weeks
in anticipation of your campus visit.
**Please Note: GROUPS WILL NOT BE ACCEPTED WITHOUT THE COMPLETION OF THIS FORM.
**Please Note: DUE TO LIMITED STAFFING AND PROGRAMMING RESPONSIBILITIES, WE UNFORTUNATELY CAN NOT EXCEPT EVERY REQUEST/MULTIPLE REQUEST THAT GETS SUBMITTED TO US. WE APPRECIATE YOUR UNDERSTANDING OF OUR CAPACITY.
If your group's demographics include other identities you would like to learn more about, please inform us of your group's population and we may be able to collaborate with other departments to cover the needs of your group.
*Please Note* OUR DEPARTMENT IS UNABLE TO LEAD ANY CAMPUS TOURS.
Please contact the
Student Outreach And Recruitment
department for campus tour inquiries.
Questions can be sent via email to the following address:
thebloc@sjsu.edu
In Solidarity,
Black Leadership & Opportunity Center (The BLOC)
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* Indicates required question
Name of school/group that will be visiting
*
Your answer
Group Lead Contact Name (First Name, Last Name)
*
Your answer
Group Lead Contact Information (Email, Phone Number)
*
Your answer
Please provide information about your organization
*
Your answer
Date of group's intended visit. MUST be a minimum of
three weeks in advance
*
MM
/
DD
/
YYYY
Time of group's intended panel presentation with the Black Leadership & Opportunity Center
*
Time
:
AM
PM
Group Size (Total including students & chaperones)
*
Your answer
Please provide information about your group. (Racial/ethnic demographics, age, grade level, etc.)
*
Your answer
Any Additional Comments?
Your answer
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