Request a Presentation | UCF Counseling and Psychological Services

Outreach Request Form

Please submit your request at least three weeks before your event.

Contact Information

Fill out your contact information below. Please ensure that this information is accurate so that we can easily contact you if needed.

A copy of the form will be emailed to you.

First and Last Name

Email Address

Phone

Best Way to Reach You

Phone
Email

Affiliation to University

Student
Staff
Faculty
Other

Organization / Department / Class

Position

Is this a program/event Wellbeing Peer Educators can participate in? (Example: Helping a Friend, Managing Stress, Mindfulness) If yes: Consider requesting a presentation from https://whps.sdes.ucf.edu/workshops/

Yes
No

Program Topic

Presentation Title

What AV equipment do you have at the presentation location?

Microsoft/IMB
Apple/MAC
Speakers
Projector and screen

Preferred date and time

Preferred length

Program location

If in person - Where is the location?

Audience

Number of Expected Participants

Attendance

Additional Information