Inclusion Champion Verification Form

If you have completed the requirements of the program, please fill out this short questionnaire to let us know.

Read more about the Inclusion Champion Program.


Inclusion Champion

Please fill out this form to receive your Inclusion Champion certificate and pin!
  • Inclusion Champion Completion Requirements

    Complete 9 hours of core workshops (ABCs of Diversity, Inclusive Communication, Understanding Power and Privilege) and 6 hours of elective topics. | Note: students must keep track of courses and verify with us to receive certificate
  • Please use the name UCF has on file for you, not any nicknames.
  • Please include any titles, prefixes, suffixes, middle initials, etc.
  • Either or
  • Students, alumni, and community members must pick up certificate and pin from our office in the Barbara Ying Center (12701 Scholarship Drive, Bldg. 81, Suite 102)
    Please select all that currently apply.
  • Course History

    Please indicate the dates of your enrollment in the three core workshops. All information is subject to verification by ODI.