Workshop Request Form
First Name *
Your answer
Last Name *
Your answer
Department/Organization *
Your answer
Email address *
Your answer
Phone number (xxx-xxx-xxxx) *
Your answer
What is your role on campus? *
Type of request *
Select topic (If it is an event table request, choose "event table"): *
Date of workshop: *
MM
/
DD
/
YYYY
Time of workshop *
Time
:
Length of workshop (typically 45-60 minutes): *
Workshop location *
Your answer
If this request is for a course, please type the course number and name:
Your answer
Estimated number of attendees (total): *
Your answer
To help us prepare, list estimated number of students by year in school or indicate if audience is staff/faculty/etc. (Eg. 10 freshman and 15 sophomores or 17 KU staff members): *
Your answer
Please describe the academic focus (major) of students in your group. If majors, vary, please indicate this: *
Your answer
What equipment/technology is available in the room in which the workshop will take place *
Required
How do you plan to advertise this workshop to your audience? *
Required
What do you hope students will learn as a result of this workshop? *
Your answer
Additional information:
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Are you a robot?
Type the characters you see above (no spaces): *
Your answer
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