Instructor Name 

Phone #    Best time to contact 

I am interested in the following kinds of classroom assistance:

Hour-long workshops

Employability Skills (professionalism, resume writing, interviewing, job searching)
Study Skills (test taking, note taking, time management, learning styles)
Career Planning (choosing a major/career, identifying interests/personality preferences)
Personal Development (leadership, diversity, stress management)

10-15 minute presentations

Financial Resources (scholarships, grants, employment opportunities)
Academic Resources (tutoring services, study groups, college skills)
Career Resources (career information, employment data, assessments

I am interested in referring an individual student for the following:

Academic Counseling
Personal Counseling
Career Counseling

Services to county center classrooms and students may be available through the PEN.  Please indicate if this applies.

Please state any additional requests or comments: