On Campus Mini Module Request Form

Complete a Mini Module Request Form for each on campus workshop you would like to request. Please give WRSA as much lead time as possible for scheduling Mini Modules — two weeks or more is ideal. As WRSA get busier serving students, it may not be possible to schedule workshops on your first choice of dates/times, so please always add a second choice. Within 24-36 hours of receiving your request, you will receive an email from WRSA to confirm your request and to ask for any pertinent assignment or support information. A confirmation email will follow with the workshop title, the date, and the time.

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First Name*

Last Name*

Email Address*

Department*

Course and Section Number*

Class Meeting Days and Times*

Number of Students*

Building and Room Number*

Is this a computer classroom?

Yes

First Choice Date

Second Choice Date*

APA Workshop Choices

ELS Workshop Choices

MLA Workshop Choices

Multimodal Workshop Choices

Reading Workshop Choices

Speech Workshop Choices

Writing Workshop Choices