College of Emergency Preparedness, Homeland Security and Cybersecurity (CEHC)
Request a visit from our CEHC Student Ambassadors
School District or Community/Industry Partner
*
Contact Email Address
*
example@example.com
Contact Name
*
First Name
Last Name
How did you learn about the CEHC Ambassador program?
*
School Name
School Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
What program are you requesting?
*
Additional comments
Describe your organization's level of participation in the event. Include classes, grade level and courses such as science, technology or math. Additionally, please indicate whether there will be a culminating activity such as a general panel discussion for the younger audience to explore engineering education with specific engineering disciplines, college preparation, etc.
*
Submit
Should be Empty: