Workshop or Presentation Request Form

About You & Your Group
Your Name*

First NameLast Name
Your UAlbany Email Address*
example@albany.edu
Your Phone Number*
Please enter a valid phone number.
Which best describes you?*

StudentFacultyStaff
Which best describes your group?*

Academic ClassDepartment or OfficeCampus OrganizationOther
Class Name*
Department or Office Name*
Campus Organization Name*
Group Name*

About Your Request
The Learning Commons is currently providing workshops or presentations on the following topics. Which topic are you requesting?*

Learning Commons Program Overview
How long of a workshop or presentation would you prefer?*

Less than 15 minutes15 minutes30 minutes60 minutes
Please provide three date and start time options for a workshop or presentation.
Preferred Date 1*

MonthDayYear
Date
Preferred Start Time 1*

Hour Minutes

AM/PM Option
Preferred Date 2*

MonthDayYear
Date
Preferred Start Time 2*

Hour Minutes

AM/PM Option
Preferred Date 3*

MonthDayYear
Date
Preferred Start Time 3*

Hour Minutes

AM/PM Option
Please provide the on-campus location where you plan to hold the workshop or presentation.
Building Name*
Room Number*
Would you like to request a specific Learning Commons staff member as the workshop or presentation facilitator?*

YesNo
Learning Commons Staff Member's Name*

First NameLast Name
Is there anything else our staff should know about your request?*
By clicking the “Submit” button, I consent to be contacted via email.
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