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Program Request Form

The Center for Wellness Promotion has health educators available to speak to UNC Charlotte students and groups. Please submit your request at least two (2) weeks in advance and provide information below. Complete one form for each program request. A health educator will contact you within 48 hours to confirm the program request has been received.

Basic Information

If you are interested in a variety of options, please select all that apply.

Please visit our website for more information about our Program Offerings.

If you would like a workshop or training on a topic not listed on this form (or a modification of what is listed on this form), please describe what you are requesting here.

Please let us know the audience size (actual or estimate).

Presentation Format

Select all that apply from the options available.

If your request is in-person, does the location have a compuser and projector/screen?
How did you learn about requesting workshops and programs offered by the Center for Wellness Promotion (CWP)?