BME Outreach
***Please submit requests 2 months or more in advance.
Requests will be filled based on student availability. There is no guarantee that we can accommodate all requests. We will respond approximately 1 month before requested dates to notify you if we can accommodate your request. If you have any questions, please contact Dr. Tracy Jane Puccinelli <tjpuccinelli@bme.wisc.edu> (BME Outreach Program Director)
Organization/School *
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Address of organization/school *
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Name of contact person *
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Phone # of contact person *
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Email of contact person *
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Class/Session/Group Name *
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Age/Grade of audience *
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Are the people in the audience in High school *
General Content/Mission/Theme of class/session/group *
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Number of students (audience) *
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Number of underrepresented minorities in class/session/group *
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Number of females in class/session/group *
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Length of class/session/meeting *
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Top 3 Requested Dates and Times of outreach *
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