Oberlin Ombuds Office

Name:

Campus e-mail:

Campus address:

Home/permanent address:

Campus phone:

Home/permanent phone:

Please indicate if you are:
Staff Faculty Grad Student Undergrad Student

If student, your major:

Year of graduation:

If staff or faculty, please list your department:

To ensure the effectiveness of the OCDC, it is essential that participants come from diverse backgrounds. Please answer the following questions as completely as possible. All answers will be kept confidential.

Please identify yourself in terms of socioeconomic background, gender, preferred pronouns, primary language, religion, ethnicity, age, sexual orientation, disability status, political orientation, etc.

What organizations do you belong to?

Why do you want to participate in mediation training and the OCDC?

What skills or experiences do you possess that make you a good facilitator of communication and a good manager/resolver of conflict?

What skills or other qualities enhance your ability to work with controversial issues in diverse groups?

Anything else you would like us to know about you?