Someone will reach out to you soon after you submit your workshop request to let you know if the date and time you requested are available for one of our Health Promotion team members to present.

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* 1. Your full name:

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* 2. Your email:

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* 3. UChicago affiliation:

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* 4. Please select a workshop topic:

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* 5. Please tell us some information about your audience (e.g., first-year students living in Max Palevsky, Harris graduate students, student RSO leaders, etc.):

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* 6. Date and time of workshop:

Date
Time

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* 7. Expected number of attendees:

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* 8. Location (Zoom, building, room number):

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* 9. What are your goals for this workshop? What do you hope the participants will learn by attending?

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* 10. Other details or comments:

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