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Program Request Form

The Center for Wellness Promotion has health educators available to speak to UNC Charlotte students and groups.  Please submit your request at least two (2) weeks in advance and provide information below.  A health educator will contact you within 48 hours to confirm the program request received.

*PIB stands for RA Program In A Box.


 

Please enter phone number as 555-555-5555.
Please Include AM or PM
Please Include AM or PM
minutes
(All presentations must be a minimum of 60 minutes)