MSU Billings Student Health Services

Don't Cancel That Class
Please complete the form below if you would like us to arrange a presentation or workshop for your class.
   
Contact Information
First Name:  
Last Name:  
Class Name:  
Class CRN:  
Phone:  
Email:  
Email Confirmation:  
   
Presentation/Workshop Information
Presentation:  
Reason for Request:
   
Preferred Dates and Times
Please indicate the dates and times you would like a presentation/workshop. We will make every effort to accommodate your request.
Date:  
Class Time
Starts:  
  Type 'A' or 'P' to switch AM/PM
Ends:  
  Type 'A' or 'P' to switch AM/PM
# of Participants Expected:
Do the students know there is
a guest speaker?
Building/Room #:  
Does the room have A/V equipment?
Would you like the presenter
to take attendance?
   
Additional Information:
   
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