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Program Request Form

Health Promotion & Health Advocate Leaders (HAVs)

Health Advocate Leaders offer a variety of interactive workshops on health-related topics that provide current health information, integrate critical thinking skills into health decision-making, teach skills necessary to adopt healthy lifestyle patterns, and connect students with useful on and off campus resources.

To request a workshop or program for your student group/organization, classroom, or residence hall, please fill out and submit the form below. Requests must be submitted at least two weeks in advance of your desired program date. Program/workshop sponsors (that's you) are responsible for advertising, room reservation and set-up, refreshments and attendance…let us know if you need assistance with getting those things done!

All programs require a minimum of 10 participants.  We reserve the right to cancel any program which does not meet this requirement.  The person requesting the program is responsible for ensuring that this requirement is met.    

 

Contact to ask questions:Dana Carpenter, Program Coordinator at dlcarp02@louisville.edu or 852-6784 or Email  Health Advocates

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Person #1 Requesting Program

(Required)
(Required)
(Required)
(Required)
Check all that apply.

Person #2 Requesting Program (optional)

Check all that apply.

Please Note: Program request submitted less than 2 weeks from presentation date may be asked to reschedule

Possible Date(s) for Presentation
Please indicate multiple dates if you have flexibility for scheduling.
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$ indicates fee for service
(Required)
Belknap/HSC


If applicable, please list other organizations which will be participating in the event
(Required)
Choose format of presentation, i.e. lecture, discussion, etc
Contact person(s) are responsible for ensuring that the minimum number of students in attendance is 10
Location Logistics
Specify what will be served below.


(Required)
If this presentation is restricted to a certain group or audience, please indicate who is invited to attend.

Submit this form by clicking submit button provided or
to contact by phone:  852-5429


THANKS for your interest in health promotion !!!

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