Carnegie Mellon University
SafeZone Program Application
Spring 2005


I am interested in becoming a member of the SafeZone program at Carnegie Mellon:


Name: ________________________________________

E-mail:________________________________________

Phone:_________________________________________

Address:_______________________________________

_____Student _____Faculty _____Staff


I would like to participate in the following SafeZone training session (please choose one, or indicate preference):

_______Sunday, February 13, 11:45am-3pm, UC-Danforth Lounge
               (applications due February 7)

_______Friday, March 25, 3pm-6pm, UC-Pake
              (applications due March 18)

______I cannot make any of these dates. Please keep me informed of future training sessions.


On a separate sheet of paper please answer briefly the following questions. Confidentiality of answers will be maintained.

(1) Why do you think that you can be a good ally?

(2) Being an ally is often challenging. Give an example where being an ally could be challenging specifically for you. (You may choose to describe a hypothetical situation, or an actual experience you had).

Please return your application to Rowshan Palmer, Student Affairs, Warner Hall 301, by the deadline, or email it to rowshan@andrew.cmu.edu. If you have any questions about the program or the application, please contact Rowshan Palmer or soho@andrew.cmu.edu.