Presentation Request Form
Thank you for your interest in Career and Professional Development programming and considering the Fleishman Center as a partner. Please fill out and submit the form below to request a presentation for your class, organization, campus club or special event that you will be hosting. Your request will be forwarded to our staff and a specific presenter will be in touch to discuss the details of your request.

Please note, should your program request fall during a similar time of a program already on the Fleishman Center programs and events calendar or we can not honor your request, we may explore co-sponsorship of that program.

For your requested program, please provide at a minimum one week advance notice and detail any special requests in the "Comments" section below. If you have any questions please contact the Fleishman Center at 607-777-2400 or email careers@binghamton.edu to request information about the status of your presentation request. We look forward to working with you! Thank you.

Contact name
Your answer
Contact phone #
Your answer
Contact email
Your answer
Program Date/Time Preferences (Please submit 3 choices)
Preference 1 (date and time)
Your answer
Preference 2 (date and time)
Your answer
Preference 3 (date and time)
Your answer
Presentation location
If faculty or staff requesting an in-class presentation, please provide the class location.
Your answer
Who is the target audience?
The more specific the better. Include the population demographics, year, majors, etc if possible.
Your answer
What is the program topic you are interested in having a staff member present?
Required
Anticipated attendance
How many students do you expect to attend this program/event?
Your answer
CRN #
If faculty or staff requesting an in-class presentation, please provide the CRN #.
Your answer
Learning Outcomes: What do you hope students will gain from attending this program?
Your answer
Comments
Your answer
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