University Foundations Presentation Request Form
University Foundations Presentation Request Form
If you have any questions, please do not hesitate to contact us at herc@eiu.edu or 217-581-7786
Instructor Name:
Instructor Name:
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First
Last
Section
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Instructor Email Address:
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Instructor Phone
Instructor Phone
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Best Way to be Reached:
*
Best Way to be Reached:
Phone
Email
Presentation Information
Presentation Topic:
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Sex is Like Pizza
How to Survive a College Diet
Stress Management
Snoozin' Like a Panther (sleep)
EIU Steps UP! Bystander Intervention
Understanding Life College Finance
Rubber Lovers (Condom Skills)
Academic Integrity
Mental Health Related Topic -- Please be specific in the "other" box below.
Other
If you chose "other" above please provide a topic below.
Classroom:
Preferred Date of Presentation:
Preferred Date of Presentation:
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MM
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DD
YYYY
Back-up Date if Preferred is Taken:
Back-up Date if Preferred is Taken:
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MM
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DD
YYYY
Time of Presentation:
Time of Presentation:
*
:
HH
MM
AM
PM
AM/PM
Additional Comments: