Presentation Request Presentation Request This form is used to request a presentation by the Office of Student Conduct Name* First Last Email* Phone TOPIC Which of the following topics would you like this presentation to address?* Brief Introduction to the Office of Student Conduct Academic Integrity Common Disciplinary Issues Confronting Academic Misconduct Other (please explain under "Notes") DATE, TIME, LOCATION Requested Date of Presentation*(NOTE: If you are requesting multiple dates, please contact the Office of Student Conduct at 919-515-2963 for further assistance.) MM slash DD slash YYYY Requested Time of Presentation*(NOTE: If you are requesting multiple presentation times for the same date, please contact the Office of Student Conduct at 919-515-2963 for further assistance.) : Hours Minutes AM PM Requested Length of Presentation*(NOTE: Most presentations are designed to last approximately 45 minutes.) 15-20 Minutes (brief introduction presentation only) 30 Minutes 45 Minutes 60 Minutes Location of Presentation*(Please include building and room number.) Is this location a smart classroom?(i.e. computer and projector?) Yes No AUDIENCE AND OTHER NOTESCore Audience for Requested Presentation* Undergraduate Students Graduate Students Faculty Staff Mixed Audience Notes:NameThis field is for validation purposes and should be left unchanged.