Presentation Request

The Center for Student Wellness offers presentations upon request for student groups, faculty and staff that address a variety of topics related to health and wellness.

Please provide the following information so that we may process your request. Keep in mind:

All requests must be submitted 2 weeks prior to the date of the intended program.
If you are requesting a workshop topic that is not advertised below, understand we may need more time (usually 1 month) to develop the program materials.
The CSW requests a minimum of 6 participants in each workshop.
The CSW has a limited number of workshops it can facilitate each week. Please include multiple date options so we can best accomodate your request!
Workshop priority goes to University of Utah students (e.g., classroom, student groups, student employment), however we can facilitate workshops for staff and faculty. Understand there may be a longer wait, so please include multiple date options.

If your group cannot accommodate one or more of the requests above, please email the CSW: wellness@sa.utah.edu.

Contact Information
* Indicates required field.

* First Name
* Last Name
* Class or Organization
* Position Faculty/Staff Student Organization Resident Assistant Other
Name of Organization
If other, please indicate group, position or title.
* Phone
(xxx-xxx-xxxx)
* Email
* Email Confirmation

Presentation/Workshop Information

* Presentation/Workshop Topic
* Reason for Request
*Presentation/Workshop Goals

Preferred Dates and Times

Please indicate the dates and times you would like training. We will make every effort to accommodate your first choice. Dates must be two weeks in advance.
*First Choice Date
(mm/dd/yyyy)
*First Choice Time Rangeto
*Second Choice Date
(mm/dd/yyyy)
*Second Choice Time Rangeto
*Third Choice Date
(mm/dd/yyyy)
*Third Choice Time Rangeto
* Number of participants expected
* How will the program be advertised?
* Buiding and Room Number
Additional information