Health & Wellness Presentation

Request Form

** Please fill this form out and e-mail information to

healthandwellness@stetson.edu

at least 2 weeks before your preferred date.

Lynn Stadelman, Health Educator will reply within 2 school days.

Program ideas are @:

http://www.stetson.edu/administration/holliscenter/presentations.php **

Your Name:

Today's Date:

Your Email Address:

Primary Phone Contact::

Presentation Topic(s) Requested:

Group Presentation is for:

Estimated number of attendees:

Possible Dates and times (please list at least 2):

Why are you requested this topic(s) for this group?:

Things you really would like to see covered?:

Stay Well!!!!

**No presentation requests will be taken after April 14th, 2008 for the spring semester...

this date is subject to change to an earlier dateif all open time slots are booked before this date.**