Custom Workshop Request Form

Custom Workshop Request Form

So we can better understand your request for a custom workshop, please provide the following information.
Note: All Fields need to be filled out.

Faculty/Staff Information
First name:
Last name:
Campus e-mail:
Campus phone:
Workshop Information
Department name:
Workshop title:
Type of workshop:
Is this a hands-on lab session?	Yes No
Additional Information
Please briefly describe the workshop you are requesting, the number of people involved, and your expectations as outcomes of the workshop.
We will be in touch shortly to discuss this oppportunity further. Thank you for your submission. Please click the submit button below.

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Bergen Community College
Center for Innovation in Teaching and Learning
E-mail: CITL@bergen.edu