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Custom Technology Workshops

Request Form

Please fill out all required (*) fields and click the 'Submit' button at the bottom of the form.

First Name: *
Last Name: *
Email Address: *
Office Phone: *
Department:
Affiliation Type: *
Academic Course Name:
Academic Course Number:
Requested Class(es): *
Specific Content Requests:
Number of Sessions:
Preferred Times and Dates:
Alternate Times and Dates:
Minimum Students: * (Must be at least 8)
Maximum Students: * (Most classes limited to 25)
Classroom (If Reserved):