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UCanGo2 Workshop Request

1.Name(Required.)
2.Title(Required.)
3.Organization(Required.)
4.Phone Number(Required.)
5.Email(Required.)
6.Preferred Event Date(Required.)
Date
7.Preferred Event Time(Required.)
Time
Time
:
8.Event Location (In-person or via Zoom)
(Required.)
9.How Many Expected to Attend?
(Required.)
10.Workshop Topic: Select All That Apply(Required.)
11.Audience: Select All That Apply
(Required.)
12.What technology do we need to provide? Select All That Apply
13.Other Comments