Thank you for completing this form. By providing us with as much information possible, you are enabling us to provide the best possible service. Please note that presenters consist of professional staff and graduate students.  The availability will depend upon the level of demand for services at the time of the request.

If no one contacts you regarding your presentation request within 5 business days, please call 317-274-2554.

 
*Your Name:
 
IUPUI Department:
 
Non-IUPUI Organization Name:
 
*Phone:
 
*Email:
 
Course Name:
 
*Is this a Learning Community class?

 
Meeting Days & Time:
 
*Age of Audience:
 
*The audience will consist of the following individuals:



  
 
*Audience members will consist of students from the following IUPUI Schools:
Please select all the apply. If not IUPUI students, please select "Not Applicable".