Student Success Workshop Request Form
Requester Information
Name
*
First Name
Last Name
SHP Email
*
example@example.com
Role of Requestor
Please Select
Faculty / Instructor
Staff / Administrator
Student
Other
This workshop is being requested for:
A class / course
A student organization
Faculty or staff group
Name of course, student organization, or department
Workshop Selection
Please select the workshop(s) you are requesting: (select all that apply)
Orientation/Intro to Student Success
Academic & Cognitive Skills
Personal & Professional Growth
Career Development
Health and Wellness
Other
Academic & Cognitive Skills (select all that apply)
Memory & Learning
Health Professions Study Skills
Test Taking Skills
Understanding Test Stress
Personal & Professional Growth (select all that apply)
Effective Communication Skills
Public Speaking
Motivation
Personality Type & Management
Group Dynamics
Career Development (select all that apply)
Interview Skills
Resume Writing
Branding/LinkedIn
Health and Wellness (select all that apply)
Stress & Time Management
Wellness and Self-Care
Request a custom workshop topic
If requesting a custom workshop, briefly describe the topic or learning goals:
Date, Time, and Location
Preferred workshop date
*
/
Month
/
Day
Year
Date
Alternative workshop date
*
/
Month
/
Day
Year
Date
Preferred start time
*
Preferred workshop length
*
30 minutes
45 minutes
60 minutes
75–90 minutes
Workshop format
Virtual (Zoom)
In person
Combination of virtual and In-Person
If in person, please select the location:
Newark campus
Piscataway campus
Other (please specify)
Room reservation status
Room already reserved
Room not yet reserved
Not applicable (virtual)
Audience Details
Estimated number of participants
*
Intended audience (select all that apply)
Undergraduate students
Graduate students
Faculty
Staff
Any accessibility needs or accommodation requests?
Yes
No
Briefly describe the accessibility needs or accommodations
Additional Information
Is there anything else the presenter should know to tailor this workshop?
Submit
Clear All Questions
Should be Empty: