Workshop Request Form
Programs are typically conducted Monday - Thursday and no later than 8 pm. All program requests need to be submitted two weeks prior to the date of the intended program.
Please provide the following information so that we may process your request and find a presenter for you. When you have completed this form, please press the Submit button at the end of the page. Ben Salazar, Psychology Intern, or Marty Green, Coordinator of Outreach and Consultation Services, will get back with you within one week.
If for some reason, you have not heard back from Ben or Marty within 7 days from the date your request, please call Ben or Marty at (765) 494-6995 or email Ben Salazar or Marty Green. If you have questions or comments feel free to contact our office.
Fields designated with an asterisk (*) are required. Submissions with blank required fields will not properly transmit to CAPS.
Please complete a separate form for each program topic requested.