Event Collaboration with SAS & SCHW

Thank you for your interest in collaborating with us! Please provide some additional information regarding your request below so that we may best direct your inquiry.

This form is not for counselling services! If you are a student looking to book a counselling session with one of our registered clinicians, please visit our website and click the BOOK NOW button:
https://counselling.students.yorku.ca/

*Important*

Please submit your request at least 14 business days prior to the event date. While we will do our best, we cannot guarantee availability and support for late submissions.
Please specify which department you are interested in collaborating with? *

Please specify which department you are interested in collaborating with? Student Accessibility Services (SAS) Student Counselling, Health & Well-being (SCHW) Both SAS & SCHW I'm not sure
Please provide a detailed description of the request/event. What is the purpose of the collaboration? What are your expectations of SAS and/or SCHW's role? *
Is this event for members of the York community (e.g. faculty, undergraduate students)? *

Is this event for members of the York community (e.g. faculty, undergraduate students)? Yes No
Who will be at the event? Check all that apply *

Who will be at the event? Check all that apply York undergraduate students York graduate students York faculty York staff Other Other
Event Participants (check all that apply) *

Event Participants (check all that apply) High school students High school educators/service providers Parents Other Other
What type of event is this? *

What type of event is this? Presentation Tabling Other Other
What is the format of the collaboration? *

What is the format of the collaboration? In-person Virtual Other Other
What is the location of the collaboration (e.g. address & room number, link)? *
How many people are expected at the event? *
What is the date of the collaboration? What is the date of the collaboration? * / MM / DD YYYY
Start Time Start Time * : HH MM AM/PM
End Time End Time * : HH MM AM/PM
If you are requesting SAS and/or SCHW to participate in part of the event only, please specify the exact time below.
Are there costs associated with this event? *

Are there costs associated with this event? Yes No Other Other
Is there anything else you would like us to know?
When do you need a response by? When do you need a response by? * / MM / DD YYYY
Contact Information

Please provide your contact information below so we can get in touch with you.
Name Name * First Last
Email *
Phone Phone * - ### - ### ####
Position/Title *
Department/Unit/Organization *

Event Collaboration with SAS & SCHW

Event Collaboration with SAS & SCHW

*Important*

Contact Information

Important