JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
COPE Programming Request Form
** If you are in distress and need to speak with someone urgently, an on-call crisis counselor can be reached 24/7 at the following numbers: **
Holy Cross 24-hour Crisis Center number: 855-418-7282
National Suicide Help Line: 800-273-8225
Sign in to Google
to save your progress.
Learn more
First name
Your answer
Last name
Your answer
Campus position
Choose
CDC
RA
Building
Your answer
Phone
Your answer
Email
Your answer
Presentation Information
Presentation topic
Your answer
Primary presentation goals
Your answer
What space do you anticipate having for this event? (e.g., classroom, library, large hall, etc.)
Your answer
Number of expected attendants
Your answer
Presentation length (minutes)
Your answer
Audience (e.g, first-year students, seniors, faculty, student orgs., teams, community members, etc.)
Your answer
Please select a date and time. Providing a primary and secondary choice along with making your request in advance (i.e., at least 2-3 weeks or more) makes it more likely that we will be able to accommodate your request.
Primary date and time
MM
/
DD
/
YYYY
Time
:
AM
PM
Secondary date and time
MM
/
DD
/
YYYY
Time
:
AM
PM
Questions or comments
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of College of the Holy Cross.
Report Abuse
Forms
