NCBI WORKSHOP REQUEST FORM

Please complete the below workshop request form and
click on the "Submit" button to send your request electronically to
Judith Kamber, Dean of Professional Development.
NECC's NCBI Trainers will be advised of your request and
two people from the NECC Team will facilitate the workshop(s).

Person requesting an NCBI Workshop:
Department:
Home Phone
or Campus Extension:

E-mail Address:
(Please Note: A valid e-mail address is required to process this form.)
Workshop Request Information
Time and Day(s) of Class or Session:
Campus and Room:
Gender Make-up of Class/Group:
(i.e. ratio of male to female)
Course/Group Name:
Approximately how many people do you anticipate attending:
Questions or any information the instructor/requestor thinks are important for the trainer(s) to know: