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Academic Skills Center Service Request

* Required Items

Please complete the following form to request a service from Academic Skills Center staff

* Department:

* Last Name:

* First Name:

* Phone Number (extension if on campus):

* Email Address:

* Choose a service type:
Academic Skills Workshop (e.g., note taking, critical thinking, critical reading, exam preparation, team building, test anxiety, information processing, etc.)
Life Skills Workshop (time or stress management)
Work with a student
Class Presentation
Information session about ASC services
Other  

More description if needed
Please describe the service, indicate the type of workshop, explain the type of information session, or the student's challenge(s), etc.).

* Staff member requested:
Hope N. Walton, Director
Roger Mancastroppa, Assoc. Director
Either
Both
Other  

* Anticipated date(s) of request :

* Have you reserved the venue?
Yes
No
N/A