Greene Center Program Request Form

Greene Center Program Request Form

Please fill out the form below to request a program on the career education topic that works best for the needs of your group or organization. Some items to note before submitting your request: If your request is approved, you are responsible for reserving a location. A minimum of 15 students must be pre-registered in Handshake at least three days prior to the date of the workshop or we reserve the right to cancel the event. You are encouraged to collaborate with other student organization and/or halls to meet this attendance requirement.
Full Name*

First NameLast Name
Contact Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@u.rochester.edu
Department or Student Organization Name? *
What date and time would you like your program to take place? (Must be requested at least 14 days in advance of intended program date/time)*

MonthDayYear
Date
Hour MinutesAM/PM Option
What is your secondary preferred date and time would you like your program to take place? (Must be requested at least 14 days in advance of intended program date/time)*

MonthDayYear
Date
Hour MinutesAM/PM Option
Which Greene Center program are you interested in? If you're not sure which program is right for your group, please mark "Unsure" and someone will reach out to you to discuss program options. *
Any other logistics or information you'd like to share with us that will help in putting on a successful program for your group?
Submission Date

MonthDayYear
Date
Should be Empty: