Weingarten Center Survey

Thank you for your interest in coordinating a program or workshop with the Weingarten Center. This form is for Penn faculty, student organizations, and our many campus partners. The information you provide will help us address your unique needs and interests.

Please provide the following information about yourself:

Name:

Email:

Phone:

Affiliation (e.g., school, student organization)

Who is the audience for this program? (select all that apply)

Undergraduates
Graduate/Professional Students
Student Workers (e.g., TAs, RAs, LAs, peer mentors)
Prospective Students
Faculty/Staff
Alumni
Other:

Additional Audience Information:

More details about the target audience:

Anticipated or estimated number of attendees:

What type of program are you planning? (select all that apply)

Workshop
In-Class Presentation
Orientation Presentation
Resource Fair
Study Session with Tutors
Training for Staff/Faculty
Other (please describe):

Which services of the Weingarten Center would you like represented in this program? (select all that apply)

Learning Strategies
Peer Tutoring
Disability Services