Webinar Request Form – Community and Professional Education

First Name*
Last Name*
Email*
Type of Virtual Event?*
Please pick from the following choices. Webinar: a virtual event that covers value add subjects in a single session or a limited series. Course Info Sessions: A short persuasive presentation, outlining course outcomes, and value propositions. Course Preview: an appointed class date and time for prospective students to attend a class as a guest.
Title of Webinar?*
Will this webinar run as one-time event or a series?*
How many times will the webinar run in the series?*
Name of course?*
Webinar description:*
Please describe the webinar, including the subject matter, the problem it solves for/the value it adds to the audience, and who is presenting.
Course description:*
Please describe the course outcomes and value propositions.
Who will moderate this event?*
Who will operate the webinar software, introduce the speakers, and assist with audience questions?
Preferred time of day for the presentation?*
- Mornings
- Lunch time
- Afternoon
- Evenings
First preferred date?*
MM slash DD slash YYYY
Second preferred date?*
MM slash DD slash YYYY
Third preferred date?*
MM slash DD slash YYYY
Date of course preview?*
MM slash DD slash YYYY
What time will the course start?*

: Hours

Minutes

AM/PM
Any Special instructions for the prospective students?*
Will the preview only last a certain amount of time? Will they receive an invitation directly from the program lead? are they allowed to ask questions during the class? etc.