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Event Request Form
Please feel the form below:
Full name:
*
Pronoun:
She, her, hers
He, him, his
They, them, theirs
Other...
Pronoun: Other...
Email:
What kind of support/collaboration are you seeking from the C-Hub team?
*
Design of the event/program
Facilitation of an event/program
Suggestions for speakers (internal/external)/ resources
Evaluation/review of an event/program
Please fill out the following fields if you are requesting help with an event:
Name of the event:
Short description:
Timing of the event:
Target audience:
Faculty members
Researchers
Graduate Students
Administrative staff
Public
Other...
Target audience: Other...
Indicate if an external party is involved in the event:
No
Yes (indicate the name of the organization):
Indicate if an external party is involved in the event: Yes (indicate the name of the organization):
What code is in the image?
*
Enter the characters shown in the image.
Leave this field blank