Rape Aggression Defense Program Application

Address/Title: Address/Title Ms. Mrs. Mr. Dr. Cadet Officer Hon. Rev. Rabbi Pastor

Full Name:

University Affiliation: Student Faculty/Staff

Hokie Passport #:

Email:

Local Address:

Permanent or Office Address:

Local Phone:

Permanent or Office Phone:

Mobile Phone:

The sessions are at the following dates and times:

Request Session: Class 1 Class 2

Class 1:

• Session I: Sept. 11 from 6-9 p.m.
• Session II: Sept. 28 from 6-9 p.m.
• Session III: Sept. 25 from 6-9 p.m.
• Session IV: Oct. 2 from 6-9 p.m.

Class 2:

• Session I: Sept. 13 from 6-9 p.m.
• Session II: Sept. 20 from 6-9 p.m.
• Session III: Sept. 27 from 6-9 p.m.
• Session IV: Oct. 4 from 6-9 p.m.

All four sessions must be attended.