IMPACT Workshop Request
Requester Name: *
Your answer
Requester Email: *
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Are you requesting on behalf of NSBE collegiate chapter? *
NSBE Chapter or Organization Name: *
Your answer
What date do you want the workshop presented? *
MM
/
DD
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YYYY
Start Time: *
Please note our program is most effective when hosted weekday evenings or weekends and presenting material between 45-90mins.
Time
:
End Time: *
Please note our program is most effective when hosted weekday evenings or weekends and presenting material between 45-90mins.
Time
:
Location: *
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Audience size: *
A/V Equipment Provided (select all that apply): *
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