Wellness Education
A department of Wellness USF

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Online Presentation Request form

Please fill out the following form.

Contact Information
Full Name :     
E-Mail:
Phone number:
Best time/way to reach you:
Organization / Department /
Residence Hall:
Presentation Details
Type of Program:

If you selected OTHER as a choice, please enter a detailed desciption of what you are looking for.
Please pick a date two weeks out from today (Try a date after 6/6/2012).
Preferred date/time: date:    time:
Alternate date/time: date:    time:
Preferred length of time for program:
Preferred location for the program:
If TBD the location needs to be confirmed at least 1 week prior to the program.
Access to Technology:         

  
    
Number of participants:
Audience Description or Specific Request
or Other Comments:
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Presentation Guidelines
• You guarantee 10 participants.
• The time frame:
     o Peer Educators latest program end time will be 10:00pm. Any programs requested to run after this time frame will be reviewed on a program by program basis.
     o Professional Health Educators: Programs are provided Monday-Friday, and the latest program end time will be 7:00pm.
• At least a 2 weeks' notice (If less than 2 weeks' notice, no guarantee and will be reviewed by staff).
• You will provide flyer for event at least 1 week before program (Submit flyer to wellness@usf.edu).
• If you are an RA you need to submit your approved program proposal to the Wellness Center 1 week prior to the program.
Please select YES if you agree to the terms and conditions stated above: