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Thank you for selecting D.E.E.P. Impact as your diversity education resource. To assist our staff in understanding your needs, please complete the request form 2-3 weeks prior to your requested event. A D.E.E.P. Impact staff member will contact you within three business days of your submission to further discuss our ability to accommodate your request. Please contact Tonya Lazdowski at or Danielle Lechner at with additional questions.

Contact Information

Note: All items are required!

Please check one of the boxes below to indicate your preferred method of contact.
(Please note that consulting appointments are conducted either in-person or via telephone. E-mail will be used to confirm a consulting appointment)

Program Information

Select the intended audience for the program.

Please select the type of program you would like to coordinate.

This program request is:

During this program, focus on one or more of the following:

What is your anticipated time frame for the program?

Please provide your intended learning outcomes for the program, in order of importance:
(A learning outcome is defined as what you expect your intended audience to learn, think, or do as a result of attending the program (e.g. - As a result of attending the training session, audience members will define the term diversity)

Logistical Details

Please enter the date, time, and location options of your program in order of preference:
1st Choice:
2nd Choice:
3rd Choice:

Is internet available at your desired location?

Is audio available at your desired location?

Please list the supplies that are available at your desired location (e.g. flipchart, markers, whiteboard, chalk and eraser, etc)

Does this program require any special accommodations so that it is accessible for the intended audience? (e.g. closed captions, interpreter)

Click 'Submit' below to send your request.


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