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IGR Course Registration Form
IGR One-Credit Course Registration
Fall 2013
Registration for Fall 2013 is now open. Email
IGRinfo@villanova.edu
for further information.
Please complete this form to register for the FALL 2013 IGR Courses.
First Name:
Last Name:
Banner ID:
Email:
Cell Number:
Class Year:
College:
Liberal Arts & Sciences
Business
Engineering
Nursing
Law
Part-Time & Continuing Studies
Major:
Gender:
:
How did you hear
about IGR?
Select all that apply
Professor
Staff/Administrator
Friend
Flyer
Other
If a Professor, please type his/her name:
:
If a Staff/Administrator, please type his/her name:
:
If you selected other, please type in:
:
How do you identify racially or ethnically?
How do you identify in terms of religion, faith, spirituality?
How would you describe your socio-economic/
class background?
Why are you interested in the Intergroup Relations (IGR)?
Have you had any previous experience with social justice projects,
classes, or dialogues about difference?
Previous Experience?
Yes
No
If so, please explain.
Will you commit to open, respectful engagement in dialogue?
Will you commit?
Yes
No
Can you commit to all twelve hours of contact time for the 1 credit course?
Can you commit?
Yes
No
How many IGR courses are you applying to take this semester?
How many courses?
1
2
3
4
5
SELECT YOUR
IGR DIALOGUE COURSES
IN ORDER OF PREFERENCE
White Racial Identity:
1st
2nd
3rd
4th
5th
Gender:
1st
2nd
3rd
4th
5th
Socioeconomic Status:
1st
2nd
3rd
4th
5th
Race:
1st
2nd
3rd
4th
5th
Identity & Interfaith:
1st
2nd
3rd
4th
5th
Advanced Race:
1st
2nd
3rd
4th
5th
Additional Comments/Questions:
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