Career Program Request Form

 
  • Descriptions of Career Program Topics
  • Requests should be made at least three weeks prior to the date preferred for your presentation.
  • Requests are granted on a first-come, first-serve basis according to staff and resource availability.
  • If multiple presentations are requested, please submit a separate form for each request.

  Please complete all information.
Contact Information:
Individual Requesting Program:    

E-mail Address:

    

Phone Number:

     Ex. 814-123-4567
Class/Group Information:
Presentation is for:    
 
Class    Student Organization or Student Group
Course Number:    Organization Name:
 
Course Title:    Advisor:
 
Department:    Advisor's E-mail Address:
 
    Advisor's Campus Phone No.:
     
Participant/Audience Information:
Number of Anticipated Participants:    
Primary Class Standing of Participants:    
Primary Major(s) of Participants:    
Program Information:
Program Topic Requested:    
Location:    
Is this room a Smart classroom?  Please note that most Career Services Center presentations require both a PC with a wall projector unit and an Internet connection.     Yes           No
Desired Length:    
Desired Date     (mm/dd/yyyy)
Desired Time:    
Alternate Date:     (mm/dd/yyyy)
Alternate Time:    
Other Program Notes: