Wellness Center

Educational Program Request

Please don't fill out this input box.

Please fill out the information below to request an outreach presentation or program from the Wellness Center. Please note that simply submitting the request does not guarantee our ability to present. Someone from the Wellness Center will contact you after your submit the request to discuss details. Please note: we need at least two weeks advanced notice to consider requests.

Contact Name (first and last)*

Contact phone number*

Contact email *

Organization Name*

Please explicitly state or describe what type of program or presentation you are requesting*

Date/Time requested*

Please describe the audience, including approximate expected number of attendees and experience with the information being presented*

Location*

Anything else that might be helpful for us to know