Outreach Request Form

Required fields are marked with an asterisk (*).

Outreach Request

Thank you for inquiring about an outreach program through the Counseling and Wellness Center. Please answer the following questions in as much detail as possible to help us respond to your request.

We kindly ask that all outreach requests allow for a minimum of two weeks advance notice. If your request is urgent or time sensitive, please let us know and we will do our best to meet your needs. While we will do our best to meet your needs, we may not be able to accommodate every request.

If you have questions or need further support, please contact the Counseling and Wellness Center at 360-650-3164 or cwc@wwu.edu.

Which format would you prefer?
What presentation are you requesting?
Who is the intended audience for this program? (Select all the apply)