Diversity Enhancement Program Community Request Form

Please fill out and submit the following form to request an event.
*NOTE: All fields are required. It is important that we have complete information to adequately assist with your request.

Type of Event:
-- SELECT -- Health fair Presentation/talk Conference or workshop Club/Organization Meeting Other
If 'Other', please describe:

Date of event (mm/dd/yyyy format):

Starting time of event:

Ending time of event:

Location of event:

Anticipated number that will be in attendance:

About the Event

What is the theme or purpose of the event?