Career Connection Presentation Request Form

Requester Name

First Last

Requester Title

Location of Presentation

Phone

Email

Career presentation requested (choose all that apply.)

Diagnostic Medical Sonography (Ultrasound)
Nursing
Medical Imaging
Physical Therapy

What is the length of time you would like the presentation to be?

What is the goal of the presentation? What topics would you like to discuss during the presentation?

What dates/times are you open to having the presentation? (Please list all that you can accommodate to allow a date that best works with our schedules.)

Expected number of students/staff in attendance?

To what grade level(s) will we be presenting? (choose all that apply.)

Freshman
Sophomore
Junior
Senior
Graduate
Staff

Additional comments, questions or concerns:

BC Family

Visitors

BC Family

Visitors

Career Connection Presentation Request Form