Your Name:

Your Phone:

Your email:

Name of your organization:

Why are you requesting a Leadership Connection workshop? Please note any challenges you are facing that the workshop facilitator needs to know.

What would you like your student organization to gain from this presentation?

Describe the audience you are requesting a presentation for. Please include age, gender, and an estimated number of participants:

What is your desired presentation length? (30 minute minimum)

What are your preferences for the date and time of the presentation.

What location do you propose for the presentation? (It is your responsibility to reserve the space.)

Please choose the general topic you would like a presentation on. Please be more specific about what the particular topic you would like is in the space provided below (Additional information). (You may only choose one- for multiple presentations return to this form, choose another topic, and re-submit.)

Communication
Membership/Group Issues
Recruitment/Training/Transition
Programming
Leadership
Skills
Service
Personal/Individual Topics

Is there any additional information the presenter needs to know?