Health Education - Presentation Request Form

Sunday , 12th of October 2008

Untitled Document

Requesting a workshop does not guarantee availability. Requests must be made two weeks prior to ensure time to coordinate. You will receive a call or e-mail to confirm the presentation. Workshops are available for Housing, student organizations, faculty academic courses. and Greek Life. All others wishing to request a workshop must call 912.478.1732.

Contact

First Name:
Last Name:
E-mail:
Phone:

Presentation

Organization/Class/Hall:

Subject:

if other:

Date of Presentation:

Time:

Location:

Expected Attendance:

Items Requested

fatal vision goggles	condoms	STD boards	contraceptive kit
penis model	testicles model	vagina model	video

Additional Information

Please identify any specific information pertinent to the presentation.

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