Outreach Request Form
Request For: Campus Events, Educational Materials, Condom / Dental Dam / Lube Packets, Student Projects (Interview or Video), Etc.
We WILL NOT fill any submitted request on the same day we receive a request. All requests should be submitted at least 5 days prior to the requested pick up date. All approved requests will receive a confirmation within 10 business days.
Counseling Outreach: Please give at least 30 days/one month notice for any workshop or presentation requests. Providers are willing to facilitate, but their schedules become booked very quickly. Please include some options for dates and times. Preference is given to those that schedule a semester in advance.
Note: Only one request per program or event will be approved.
The following information will be sent via unencrypted e-mail. If you prefer, you can complete an event request form in our office.
Please enter your group information below and select "Submit" at the end of the form.