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Request a Program

Counseling and Psychological Services is always eager to work with faculty, staff and students to present on any of the listed educational topics below.

Presentations can be tailored to meet your group’s needs and scheduled at a time and location that is convenient for you. Please complete the form below to request a presentation for your class, organization or event.

Program request instructions:

  1. Please make all program requests at least two weeks in advance.
  2. A minimum of 10 participants is required (class presentations are exempt from this minimum).
  3. A professional staff member or group representative needs to be present during the entire presentation.
  4. Complete each of the fields below.
  5. Click the “Submit” button.
  6. One presentation request per form.
  7. A staff member will contact you within three business days to discuss your request.
Program Request Form
Contact person:
Phone number:
Email address:
Course number or audience description:
Number of participants:
Program location:
Name of representative to be present at event
(if different from contact person above):
Requested Dates and Times
(Please provide three options, listed in order of preference.)
First choice date:
First choice time:

Second choice date:
Second choice time:

Third choice date:
Third choice time:
Requested Program Topic(s)
 Academic performance
 Alcohol use and abuse
 Autism Spectrum Disorders (ASD)
 Being homesick
 Body image
 Bullying and harassment
 Conflict resolution
 Drugs of abuse
 Eating disorders
 Family issues
 Roommate problems
 Sexual violence and sexual assault
 Sexual minorities/LGBTQ issues
 Sports performance
 Stress management
 Suicide awareness and prevention
 Time management
 SNC in 3D
 Other (Specify):
Additional information (optional):

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