Schedule A DOC Talk

Posted September 24th, 2007 by admin

The form below allows you to request a DOC talk for your classroom.
Please call Sharon Younkin at (608) 262-4204 if you need further assistance in making your request.

Name: *

Position:

School: *

Email: *

Street Address:

Work Phone:

Home Phone:

Choose a topic:

Specify Topic:

Please allow flexibility in scheduling so that DOC students can accommodate your talk. Four weeks advance notice is requested.

Date(s) of Presentation:

Time(s) of Presentation:

(afternoons best)

Class Size:

Grade Level:

Please include human organ specimens in presentation.:

Comments:

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Utilities

Department of Family Medicine

Schedule A DOC Talk