If you are requesting a program for University Foundation courses, please do so using this link: https://www.eiu.edu/herc/machform/view.php?id=46276

H.E.R.C. Program Request Form

Note: Please place requests two weeks in advance to ensure availability of your program.

Name: Name: * First Last
Department/Organization: *
Campus Location/Address: *
Phone Number:
Email Address: *
Best Way to be Reached: *

Best Way to be Reached: Phone Email
Presentation Information
Presentation Topic: *
If you chose "other" above please provide a topic below.
Date of Presentation: Date of Presentation: * / MM / DD YYYY
Time of Presentation: Time of Presentation: * : HH MM AM/PM
Location of Presentation: *
Length Requested: *
Presentation Style: *

Presentation Style: Lecture Panel Discussion Other
If Other:
Technology Available: (Computer and Projector) *

Technology Available: (Computer and Projector) Yes No
Additional Comments:

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