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Your Contact Information:

Name:

Email

Phone

Dept. or Student Group:

Expert Speaker/Facilitator

Training

Workshop

This Event Is:

In-Person Event

Virtual/Online

Event Location:

Virtual Platform:

Audience Information

Special Student Population(s):

Faculty/Staff/Administration:

Expected Attendance:

How many people do you anticipate will be in attendance?

Expectations:

Level of Engagement:

Discuss the Services Offered by the Department of Counseling Services

Facilitate a discussion on a mental health or wellness topic

Contribute to a panel presentation as a mental health expert

Formal Presentation on a mental health and wellness topic

Provide an experiential activity on a mental health and wellness topic

Expected Learning Outcomes:

Expected Topic/Subject of Training/Presentation:

Time Allotted:

15 Minutes

30 Minutes

45 Minutes

60 Minutes

Other

Other Time Allotted:

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