Program Request Form
The Wellness Resource Center has so much to offer in regards to educational programming! Both our HEART Peer Educators and professional staff members facilitate programs, trainings, and other opportunities to assist you in educating Owls all over campus!

For regularly offered programs and tabling requests, we require at least 2 weeks' notice from the requested date(s).

We are happy to create a custom program to suit your needs; however, we require at least 4 weeks' notice for custom programs and a planning meeting or phone call to ensure that the goals of the custom program are clear. If you can provide more than 4 weeks' notice, it is greatly appreciated.

Cancellation: If you need to cancel a program once it is scheduled, we require 24 hours' notice via email.

You will be contacted by a staff member once your request has been received. If you have questions about your request, please email us at tuheart@temple.edu or call us at 215-204-8436.

Email address *
Your name *
Your answer
Your TU email address. *
Your answer
What is your department or student organization? *
Your answer
What is your reason for requesting a program? *
Your answer
Number of anticipated attendees. *
Your answer
Location for the program. *
Your answer
Please provide your preferred date for the program. *
MM
/
DD
/
YYYY
Start Time (or the time you need the WRC to begin at your program) *
Time
:
End Time (or the end time you need the WRC to be present at your program)
Time
:
If we are unable to accommodate your initial date/time requested, please provide an alternative date and time. If the date/time you provided is the only available date, please say so below. *
Your answer
Is there anything else you'd like us to know about facilitating a program for you? Note: If you are requesting a custom program, please provide details and context here for what you are requesting.
Your answer
Who would you like to facilitate this program? (Note that program offerings may differ based on facilitators. See our website for more details) *
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