Peer Program Presentation Request Form: The Blues Project Fall 2019
The Blues Project is a peer education program through University Counseling Services that conducts psycho-educational presentations in the area of depression education and suicide prevention. Topics in these presentations include understanding myths and stigmatizing language around suicide, methods to support students in distress, and community resources or programs that may assist students in these areas. To request a presentation, please complete the brief questionnaire in the link below.

You will receive an email within a week of your request as confirmation.

For questions, please email Steven Wang (Peer Education Coordinator) at Steven.Wang@csun.edu
First/Last Name of Peer Educator Generating Presentation (For Professors: Please mark: "N/A") *
Your answer
Person A (For Professors: Please mark: N/A) *
Your answer
Person B (For Professors: Please mark: N/A) *
Your answer
Date of Presentation (Please schedule presentation date at least 7 days from today) *
MM
/
DD
/
YYYY
Time of Presentation (e.g. 8:30 AM) *
Time
:
Length of Presentation (e.g. 30 minutes - 1 hour) *
Professor's Name *
Your answer
Professor's Email Address (e.g. Matty.dor@csun.edu) *
Your answer
Course Number (e.g. Psych 321, Soc 1, etc.) *
Your answer
Room Location (e.g. SH 213) *
Your answer
Class Size (e.g. 30 students) *
Your answer
What technology is available? (e.g. Smart Room, Black Box access, etc.) *
Your answer
Additional Comments/Feedback? (If none, please mark: N/A) *
Your answer
Thank you for scheduling a presentation with the Blues Project program! Within 72 hrs of submitting your request, we will send you a confirmation email of your scheduled presentation with your request details.
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