In-Class Workshop Request Form

Instructor Name

Instructor E-mail

Course (e.g. Bus 100)

Workshop Topic Requested

Date and Time - First Choice

Date and Time - Second Choice

Length of Workshop

Room Location

The U of R collects information under authority of The University of Regina Act in accordance with the Local Authority Freedom of Information & Protection of Privacy Act and the Personal Information Protection & Electronic Documents Act for purposes of enrolment, academic status, and administration of programs/services. By responding to this form, you consent to the use of your personal information to communicate with you regarding Student Success Centre initiatives.