Diversity of University Peers 4.C Form
Current Status:
Intern Name:
Major(s):
Today's Date: 12/9/2022 10:04:11 AM

Identify Diverse University Peers

For program improvement purposes, the School of Education is collecting information about specific interactions with diverse peers. Self report your experiences interacting with diverse peers in your classes or through other experiences during your program of study.

Diverse Individual 1
Race or Ethnic Group (other than your own) of Diverse Individual 1:
Semester and Year:
School(s) or Sites(s):
Identify Type of Experiences (Select all that apply):
If Other, please describe:
Was this peer of a different gender than yourself?
Was this peer of a different socioeconomic group than yourself?
Diverse Individual 2
Select a Race or Ethnic Group (other than your own) with whom you have had experience (2):
Semester and Year:
School(s) or Sites(s):
Identify Type of Experiences (Select all that apply):
If Other, please describe:
Was this peer of a different gender than yourself?
Was this peer of a different socioeconomic group than yourself?
Individual with Identified Exceptionalities
Have you interacted with a peer with identified exceptionalities?
Semester and Year:
School(s) or Sites(s):
Identify Type of Experiences (Select all that apply):
If Other, please describe:

  

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