Contact Person:

Phone:

Email:

Workshop Title:

Presenter:

Presenter Email:

Originating Campus*: --- Select One --- Clear Lake Campus Woodland Community College Yuba College (*determines which College processes this workshop and has the reponsibility for approving it.)

Begin Date: 11 ---------- 010203040506070809101112 20 ---------- 01020304050607080910111213141516171819202122232425262728293031 2009 ---------- 200820092010201120122013 (MM/DD/YYYY)

End Date (Optional): ---------- 010203040506070809101112 ---------- 01020304050607080910111213141516171819202122232425262728293031 ---------- 200820092010201120122013 (MM/DD/YYYY)

Time: (include both the Start Time and End Time)

Room:

Location: Select One ----- Clear Lake Campus Distance Learning Woodland Community College Yuba College Other

Audience by Campus/DE: (you can select one, many or all)

Clearlake  Yuba  Woodland  Distance Learning 

Flex Hours:

Brief Description of Workshop or Event:

Target Audience: (check all that apply)

Faculty   Classified   Administration   Students  

Equipment needs or special participant requirements either prior or during activity: