MSU Sexual Assault Program Community Outreach Request Form
Please complete the form below. Direct your questions to Tana Fedewa, Sexual Assault Program Coordinator at tanaf@cc.msu.edu
Email address
Type of Request
Required
Are you requesting a SAP Professional or a SACI Volunteer?
Name of Event
How should we reference this event?
Date of the Event
MM
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DD
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YYYY
Time of the Event
Time
:
Anticipated Length of presentation
Event Description
Your answer
Expected Audience
Required
Estimated number of attendees
Contact Person
Your answer
Email address
Your answer
Phone Number
Your answer
The date of this request
MM
/
DD
/
YYYY
You must submit requests 1-2 weeks before the actual event. We will make every effort to fulfill your request, if we are not able to we will notify you.
Your answer
Additional Comments or Information
Your answer
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