Request a Health Promotion Program or Presentation

  1. Submit an online request at least 10 business days in advance. Please note that all Program Request should start no later than 7:30pm. 
  2. After submission of your online request, you will receive a response from a Department of Health Promotion staff member. Response may take up to 48 hours. If you have not been contacted by a Health Promotions staff member or have not received the Program Confirmation Form please contact Michael Hines at m.hines@unf.edu or (904) 620-1570.
  3. Once you have received confirmation of your request, we recommend that you advertise your program. You can do this through flyers, e-mail, word of mouth, Osprey Update, and any other means of promotion. (Use these avenues of advertisement if applicable to your program)

 

Please fill out the form below. Separate multiple email addresses with a semicolon (;).

Name:  
E-mail:  
Phone:  
Classification:
                     
Subject Area:  

Description of Program Requested: 

   

Requested Program

Facilitation and Materials: 
 
Check all that apply.  
                     

 

Title of Program:
 
Location of Program:
 

Possible Date & Time of Program:

 

Please Indicate at least two possible dates:

 [None] Select a Date Delete the Date   Time:

 [None] Select a Date Delete the Date   Time:

Name of Group / Class:
 

Demographics of Group:

 If your group has an abundance of one specific gender, age, nationality, or race, please specify here.

 

 

 


I understand that by submitting this form, I am not scheduling a program request at this time. I understand that someone from the UNF Department of Health Promotion will contact me and let me know if or when they can meet my need. We require that you submit your request at least 10 business days before the requested program date.