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Wellness Outreach Request Form

Thank your interest in hosting a Wellness at Penn event! All of our events are designed to support our mission of infusing wellness across the 8 Domains of Wellness through inclusive, innovative, and impactful initiatives. Events are facilitated by professionals with expertise in public health, health education, medicine, psychology, and social work.

Please fill out and submit this form and a Wellness at Penn staff member will reach out to coordinate your event within 3 business days. Requests should be submitted at least 2 weeks before your event to ensure staffing availability.

Your Name

Your Email

Event Type

Orientation
Resource Fair
Workshop
Penn Farm: Tour
Penn Farm: Tour & Volunteer
Other - Please describe

Event Date
To ensure adequate planning and advertising time, please request a date that is at least 2 weeks in the future

Event Time
(Ex. 11:00am-12:00pm)

Event Location

Requesting on behalf of:

Academic School
Athletics
College Housing and Academic Services (CHAS)
Cultural Resource Center
Fraternity and Sorority Life
International Support Office
Graduate Student Center
Student Organization
Other - Please Specify

Which academic school are you requesting for?

Which college house are you requesting for?

Are you planning to create print and/or digital advertising materials for this event?

Yes
No

Since you are planning to create advertisement materials for your event, please follow the guidelines below:

Once you are connected to a facilitator, they will provide our logo and language about our department to include in your advertisement, please feel free to ask for this information directly if you do not recieve it
Once you've completed the drafts of your advertising materials, please share them with your assigned facilitator so they can offer feedback and get the sign off from our Communications team
If you are going to post the advertising materials on social media and would like Wellness to share them to our Instagram story, please tag @WellnessatPenn in your photo and/or caption
We recommend advertising your event for at least 7-10 days leading up to the event
If you have any questions or concerns, please connect with your assigned facilitator

Would you like us to create advertising materials for this event?

Yes
No, we would like to create the advertising materials for this event
No, we are not planning to create advertising materials for this event

We would be happy to create advertising materials for this event! Once we connect you with a facilitator, we will include our Communications and Engagement Manager on the email as they will assist in advertisement creation

Thank you for your willingness to create the advertising materials. In collaboration with our Communications team, we have developed some guidelines we ask you to follow:

When we connect you with your event facilitator, they will provide our logo and language to describe our department for use in your advertisement, please feel free to ask your facilitator for this information if you do not recieve it
Please share your advertisment with your facilitator ahead of posting it so we can offer feedback and approval from our Communications team
If you are posting your advertising materials on Instagram:
- If the event is open to all of most of the Penn community, you are welcome to invite @WellnessatPenn as a collaborator for your post
- If the event is limited to a specific group or substet of the population, you can tag @WellnessatPenn in the photo and/or caption of your post and we will repost it on our story
If you have any advertising questions or concerns, please let your facilitator know as they will be happy to assist you

Does this initiative support any of the following communities?
Select all that apply

International Students
Students of Color
First Generation and/or Low-income Students
LGBTQ+ Students
Religious Communities
Students with Disabilities
Non-traditional Students
Other

Anticipated number of attendees

Attendees

Students
Facutly/Staff
Mix - Students/Faculty/Staff
Other

Which students?

Undergraduate
Graduate/Professional
Mix - Undergraduate/Graduate/Professional

Are you currently planning this event with a staff member from Student Health and Counseling or Public Health and Wellbeing?

Yes (Please list the staff member's name below)
No

Please tell us more about the event, if you have any special considerations, or want to request a staff member with a particular identity.