Workshop Request Form

To request a workshop, please fill out and submit the form below. Workshop requests must be submitted at least two weeks in advance of your desired program date. You will be contacted shortly regarding your request.

Your Information:
Name:
Phone: Email:
Organization:

Workshop Content:
Workshop Choose Workshop Here Stress Management Eating Disorders/Body Image Substance Use Personal Growth Adjustment Concerns Dissertation Relationships Identity Concerns Mental Health Issues Gender Issues Career Concerns CAPS Services Effective Communication Crisis Intervention (please choose one)
Introduction to CAPS
Reception/Table at Fair
Panel
Other, please specify:

Brief Description:

 

Suggested Title:

 

Workshop Audience:

If this workshop should be geared to a particular audience, please specify one, otherwise leave blank: Choose Audience Here African-American Asian-American Athletics Female Students Frat/Sor Grad Students International Students Latino Students LGBT Students Male Students Minority Students Religious Orgs Residential Life General Audience

Workshop Specifics:
Preferred Date: (mm/dd/yy) 
Day of the Week: (Mon, Tues, Wed...)
Start Time: (3 pm)   End Time: (3 pm) 
Location for Workshop:
Expected Attendance:

Additional Comments: