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Presentation and Outreach Request
Contact:
First Name*
Last Name*
Email*
Telephone*
Organization name
Organization address
Audience:
ELEMENTARY STUDENTS
ELEMENTARY STUDENT GRADE 4
ELEMENTARY STUDENT GRADE 5
ELEMENTARY STUDENT GRADE 6
ELEMENTARY STUDENT GRADE 7
ELEMENTARY STUDENT GRADE 8
HIGH SCHOOL STUDENTS
HIGH SCHOOL STUDENT GRADE 9
HIGH SCHOOL STUDENT GRADE 10
HIGH SCHOOL STUDENT GRADE 11
HIGH SCHOOL STUDENT GRADE 12
UNIVERSITY STUDENTS
EDUCATORS
HEALTH PROFESSIONALS
Length of Request:
1 HOUR
1.5 HOURS
2 HOURS
Workshop Type:
WEBINAR
ON-SITE (GTA ONLY)
Required Accomodations:
FIRST
SECOND OPTION
THIRD OPTION
Number of Attendees:
Select a number
5-10
10-30
30-50
50-100
100+
Select a Date:
First choice date*
First choice time*
Second choice date*
Second choice time*
Submit Request
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