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Program Request Form

If your group or department would like to host a workshop, or develop a hybrid workshop specific to your group, fill out and submit the short form below. PLEASE ALLOW AT LEAST TWO WEEKS PRIOR TO EVENT TO PROCESS REQUEST.

NOTE: ALL FIELDS MUST BE FILLED OUT. Do not press "Enter" until ready to submit. Shortly after the form is submitted a staff member will contact you.

Contact Name (First & Last)
Telephone #
E-mail
Organization Name/Type
Program Topic
Suggested Format
1st Choice Program Date & Time
2nd Choice Program Date & Time
3rd Choice Program Date & Time
Event Location
Equipment Provided
Attendance Expected (you must guarantee 10 people minimum)
How Will Program Be Advertised?
Program Audience
Comments/Questions/More Info