Health Promotion Services Event Request Form

Requestor's Name *

Name of Organization/Class *

Name and/or Brief Description of Event *

E-Mail *

Contact Number *

Primary Contact Number for Day of Event *

Topic of Event *

If you would like a topic not listed, please email healthycats@txstate.edu.

Sexual Health

Alcohol and Other Drugs

Stress Management

Healthy Student Behaviors

Consent and Healthy Relationships

Stalking Awareness

Red Flags in Relationships

Type of Event *

If you would like an event type not listed, please email healthycats@txstate.edu.

Passive Programming

(Event in a box, you will be given the tools to facilitate your own event)

Tabling

(You will need to provide us with space to table, a table, and chairs)

Health Education Activity

(Examples: Question wheels, build-your-own kit, presentations etc.)

Bingo

Trivia

Kahoot

Preferred Date for Presentation *

Second Preferred Date (must be a different date than first preferred) *

Third Preferred Date (must be a different date than first and second preferred) *

Start Time *

A.M. or P.M.?

a.m.

p.m.

End Time *

A.M. or P.M.?

a.m.

p.m.

Expected Number of Attendees *

Location *

Submit