Intercultural Skills Development Program Application

Information in BOLD is required.

Basic Information

1. Full Name:
2. Street Address:
   
3. City:
4. State: Zip:
5. Daytime phone:
6. Fax:
7. Email address:
8. Job title:
9. Office/department:
10. How long have you worked at Duke?

Training

1. The level of formal training you have received in intercultural work: Please select one None Beginner Intermediate Advanced
2. What types of cross cultural workshops have you participated in? Please explain. Examples include intercultural compentency, diversity, ally, cross-cultural sensitivity and awareness, intercultural communication, etc.
   
3. What International House programs have you attended?

   Cultural Lunches Culture Nights/Global Stops	Cross-Cultural Trainings ACIREMA	Part I: Effective Intercultural Competency Cross Cultural Conflict Transformation and Problem Solving
   Other, please specify

Your Background and Experiences

Please note: Questions 1-3 are optional.

1. Ethnic/racial/cultural background:
2. Age:
3. Gender: Please select one Male Female
4. Place of birth:
5. Languages spoken:
6. Do you interact with international students, scholars, and/or colleagues in your job? If so, how?
   
7. Why are you interested in participating in the Intercultural Skills Development Program?
   
8. What skills and knowledge to you hope to take from the ISDP program?
   
9. How might your involvement in the ISDP program benefit your office/department and support the greater international community at Duke?
   
10. Have you reviewed the ISDP calendar and received support from your supervisor to participate in the program for the entire semester? Please select one Yes No