REQUEST A PROGRAM Peer Educators offer interactive presentations, Q&A discussions, and educational programming on campus. We will tailor the program to your area of interest and the needs of your group. We can also co-sponsor programs and events with other SHU clubs and organizations. If you are interested in having the Peer Eds provide a program for your class, residents, teammates, etc. please fill out the following form: First Name: * Last Name: * Email Address: * Cell Phone: ### - ### - #### Dorm Elizabeth Ann Seton Hall Thomas Merton Hall Angelo Roncalli Hall Jean Donovan Hall Oscar Romeo Hall Dorothy Day Hall Augustine Hall Thomas Aquinas Hall Theresa of Avila Hall John Henry Newman Hall Parkridge Taft Commons Oakwood Park Royal Other Room Number: Class Year: - Select One - Freshman Sophomore Junior Senior I am a * Resident Assistant Student Faculty Member Staff Member Residential Life Staff Other Date & Time of Program: * Location for Event: * Have you reserved this location yet?: * Yes No Audience: - Select One - Freshman Sophomores Juniors Seniors Mixed Program Topics * Stress Less Healthy Relationships Alcohol Safe is Sexy (STD prevention) Other How many students do you expect to attend this program?: * What would you like your students to gain from our program?: Additional information to help us tailor the program to your group’s needs: Do Not Fill This Out