  {"id":8,"date":"2023-07-24T13:22:03","date_gmt":"2023-07-24T17:22:03","guid":{"rendered":"https:\/\/www.ramapo.edu\/health-promotion\/?page_id=8"},"modified":"2026-07-07T16:39:52","modified_gmt":"2026-07-07T20:39:52","slug":"outreach-request-form","status":"publish","type":"page","link":"https:\/\/www.ramapo.edu\/health-promotion\/outreach-request-form\/","title":{"rendered":"Outreach Request Form"},"content":{"rendered":"<h2 style=\"text-align: left\">Outreach and Education from the Center for Student Wellness<\/h2>\n<p>Thank you for your interest in partnering with the Center for Student Wellness for an outreach presentation or co-sponsorship.<\/p>\n<ul>\n<li><strong>Outreach presentations<\/strong>\u00a0are when a representative from the Center for Student Wellness comes to your class, club, or organization for an engaging and educational presentation.<\/li>\n<li><strong>Co-sponsorship requests<\/strong> refer to when a department, club, or organization is seeking support for a campus event they are conducting (planning, promotion, attendance, etc.). For example, Health Promotion could provide give aways for a student group hosting a discussion on a wellness topic and promote the discussion.<\/li>\n<\/ul>\n<div class=\"accordions\">\n<div class=\"item\"><p class=\"question\" tabindex=\"0\"><span class=\"fa-stack\"><i class=\"fa fa-circle fa-stack-2x\"><\/i><i class=\"fa fa-plus fa-stack-1x fa-inverse\"><\/i><i class=\"fa fa-minus fa-stack-1x fa-inverse\"><\/i><\/span> DON'T CANCEL THAT CLASS\/MEETING!<\/p><div>\n<p>Center for Student Wellness staff are available to speak with clubs, organizations, and classes on campus. Before cancelling a meetings or class, please consider having one of the professionals on our staff come in to speak on one of the topics in the form below.<\/p>\n<\/div><\/div>\n<div class=\"item\"><p class=\"question\" tabindex=\"0\"><span class=\"fa-stack\"><i class=\"fa fa-circle fa-stack-2x\"><\/i><i class=\"fa fa-plus fa-stack-1x fa-inverse\"><\/i><i class=\"fa fa-minus fa-stack-1x fa-inverse\"><\/i><\/span> Wellness Is Now Peer Education Outreach Presentation Descriptions<\/p><div>\n<p>The Wellness Is Now Peer Educators are available for interactive, peer to peer events surrounding wellness topics for student clubs and organizations. They collaborate with the <a href=\"https:\/\/www.ramapo.edu\/csi\/ovp\/\">Office of Violence Prevention&#8217;<\/a>s Violence Intervention Peers to bring the Healthy Love Party to your residence hall, club, or organization! You can learn more about how to become a Wellness Is Now peer educator <a href=\"https:\/\/www.ramapo.edu\/health-promotion\/peer-education\/\">here.<\/a><\/p>\n<p>The current programs available to be requested by WIN Peer Educators include:<\/p>\n<ul>\n<li>Love Your Selfie \u2014 In this self-esteem and self-love oriented outreach events, participants will explore positive and negative self-talk, discuss how social media sites can impact our self-esteem, and describe positive qualities in themselves.<\/li>\n<li>Stress: Finding the Balance \u2014 Participants will explore different types of stress, common positive and negative activities often used to decrease stress, and ways to approach stressors within and outside of their control.<\/li>\n<li>Dealing with Depression \u2014 Participants learn more about the signs and symptoms of depression, how brief exercise can improve mood, and options for help with depression in their community and on campus.<\/li>\n<li>Sleep for Success \u2013 Participants will learn about the science of sleep, how it connects to physical and emotional health, and engage in interactive activities to build a sleep plan and a sleep self care kit.<\/li>\n<li>The Healthy Love Party (with the Office of Violence Prevention Violence Intervention Peers) \u2013 Healthy Love Parties offer an engaging and relatable way to learn about safe and enjoyable sex. Topics include barrier methods, consent 101, campus resources, and ways to reduce the risk of STIs and unintended pregnancy. The session concludes with fun review games to reinforce learning.<\/li>\n<\/ul>\n<\/div><\/div>\n<\/div>\n<h3 style=\"text-align: left\">Outreach and Co-sponsorship Request Form<\/h3>\n<ul>\n<li>Outreach requests will be evaluated on a case by case basis.<\/li>\n<li><strong>Please give advance notice (preferably 3 weeks). <\/strong><\/li>\n<li>Fill out the fields below, click &#8220;submit,&#8221; and someone will be in touch with you as soon as possible.<\/li>\n<li>Different outreach presentations are available from the Center for Student Wellness. Please ensure you select the correct group you are seeking outreach from in the form.<\/li>\n<\/ul>\n<p>To ensure that we are meeting the needs of your community with our programming, please indicate in the form details about your class, office, or student organization and any specific discussion topics you would like us to address.<\/p>\n\t\t<script type=\"text\/javascript\">\n\t\t\tjQuery(document).ready(function(){\n\t\t\t\tvar prmstr = window.location.search.substr(1);\n\t\t\t\tvar prmarr = prmstr.split (\"&\");\n\n\t\t\t\tfor ( var i = 0; i < prmarr.length; i++)\n\t\t\t\t{\n\t\t\t\t\tvar tmparr = prmarr[i].split(\"=\");\n\t\t\t\t\tvar origVal = decodeURIComponent(tmparr[1]);\n\t\t\t\t\tvar modifier = origVal.substr(0,1);\n\t\t\t\t\tvar theField = jQuery(\"#\"+tmparr[0]);\n\t\t\t\t\tif(modifier == '^')\n\t\t\t\t\t{\n\t\t\t\t\t\tvalue = origVal.substr(1);\n\t\t\t\t\t\ttheField.attr('readonly','readonly');\n\t\t\t\t\t}\n\t\t\t\t\telse\n\t\t\t\t\t{\n\t\t\t\t\t\tvalue = origVal;\n\t\t\t\t\t}\n\t\t\t\t\ttheField.val(value);\n\t\t\t\t}\n\t\t\t});\n\t\t<\/script>\n\t\t<div class=\"frm_forms  with_frm_style frm_style_formidable-style\" id=\"frm_form_2_container\" data-token=\"16407ec728ca1b4e70d5e9fea0f901ea\">\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_outreach-fork\" data-token=\"16407ec728ca1b4e70d5e9fea0f901ea\">\n<div class=\"frm_form_fields \">\n<fieldset>\n<legend class=\"frm_screen_reader\">Outreach form<\/legend>\r\n\r\n<div class=\"frm_fields_container\">\n<input type=\"hidden\" name=\"frm_action\" value=\"create\" \/>\n<input type=\"hidden\" name=\"form_id\" value=\"2\" \/>\n<input type=\"hidden\" name=\"frm_hide_fields_2\" id=\"frm_hide_fields_2\" value=\"\" \/>\n<input type=\"hidden\" name=\"form_key\" value=\"outreach-fork\" \/>\n<input type=\"hidden\" name=\"item_meta[0]\" value=\"\" \/>\n<input type=\"hidden\" id=\"frm_submit_entry_2\" name=\"frm_submit_entry_2\" value=\"4a84de4e35\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/health-promotion\/wp-json\/wp\/v2\/pages\/8\" \/><div id=\"frm_field_6_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label id=\"field_aa5k9_label\" class=\"frm_primary_label\" for=\"field_aa5k9\">Name\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_aa5k9\" name=\"item_meta[6]\" value=\"\"  data-reqmsg=\"Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_aa5k9\" \/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_aa5k9\">First<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_7_container\" class=\"frm_form_field form-field  frm_required_field frm_hidden_container frm6\">\r\n    <label id=\"field_rmbp_label\" class=\"frm_primary_label\" for=\"field_rmbp\">Last Name\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_rmbp\" name=\"item_meta[7]\" value=\"\"  data-reqmsg=\"Last Name cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_rmbp\" \/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_rmbp\">Last<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_8_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first\">\r\n    <label id=\"field_en3gk_label\" class=\"frm_primary_label\" for=\"field_en3gk\">Email\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"email\" id=\"field_en3gk\" name=\"item_meta[8]\" value=\"\"  data-reqmsg=\"Email cannot be blank.\" aria-required=\"true\" data-invmsg=\"Email is invalid\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_20_container\" class=\"frm_form_field form-field  frm_top_container vertical_radio\">\r\n    <div id=\"field_ruu0z_label\" class=\"frm_primary_label\" for=\"field_ruu0z\">Who are you?\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" role=\"radiogroup\">\t\t<div class=\"frm_radio\" id=\"frm_radio_20-0\">\t\t\t<label  for=\"field_ruu0z-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[20]\" id=\"field_ruu0z-0\" value=\"Student\"\n\t\t data-invmsg=\"Who are you? is invalid\"   \/> Student<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_20-1\">\t\t\t<label  for=\"field_ruu0z-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[20]\" id=\"field_ruu0z-1\" value=\"Faculty\"\n\t\t data-invmsg=\"Who are you? is invalid\"   \/> Faculty<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_20-2\">\t\t\t<label  for=\"field_ruu0z-2\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[20]\" id=\"field_ruu0z-2\" value=\"Staff\"\n\t\t data-invmsg=\"Who are you? is invalid\"   \/> Staff<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_21_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container vertical_radio\">\r\n    <div id=\"field_dfb3c_label\" class=\"frm_primary_label\" for=\"field_dfb3c\">Are you requesting co-sponsorship for an event or an outreach presentation from the Center for Student Wellness?\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_opt_container\" role=\"radiogroup\" aria-required=\"true\">\t\t<div class=\"frm_radio\" id=\"frm_radio_21-0\">\t\t\t<label  for=\"field_dfb3c-0\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[21]\" id=\"field_dfb3c-0\" value=\"Co-sponsorship\"\n\t\t data-reqmsg=\"Are you requesting co-sponsorship for an event or an outreach presentation from the Center for Student Wellness? cannot be blank.\" data-invmsg=\"Are you requesting co-sponsorship for an event or an outreach presentation from the Center for Student Wellness? is invalid\"   \/> Co-sponsorship<\/label><\/div>\n\t\t<div class=\"frm_radio\" id=\"frm_radio_21-1\">\t\t\t<label  for=\"field_dfb3c-1\">\n\t\t\t\t\t<input type=\"radio\" name=\"item_meta[21]\" id=\"field_dfb3c-1\" value=\"Outreach Presentations from the Center for Student Wellness\"\n\t\t data-reqmsg=\"Are you requesting co-sponsorship for an event or an outreach presentation from the Center for Student Wellness? cannot be blank.\" data-invmsg=\"Are you requesting co-sponsorship for an event or an outreach presentation from the Center for Student Wellness? is invalid\"   \/> Outreach Presentations from the Center for Student Wellness<\/label><\/div>\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_24_container\" class=\"frm_form_field frm_section_heading form-field  frm12 frm_first\">\r\n<h3 class=\"frm_pos_top\">If co-sponsorship:<\/h3>\r\n<div id=\"frm_desc_field_42zr7\" class=\"frm_description frm_section_spacing\">What event are you requesting sponsorship for? Please provide details including the topic, event description, date, time, and who you are requesting cosponsorship from in the Center for Student Wellness. Please also specify what your co-sponsorship entails (marketing, funding, resources, swag, tabling, etc.)<\/div>\r\n\r\n<div id=\"frm_field_12_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm12 frm_first\">\r\n    <label id=\"field_vvm72_label\" class=\"frm_primary_label\" for=\"field_vvm72\">Event Description\r\n        <span class=\"frm_required\">*<\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[12]\" id=\"field_vvm72\" rows=\"5\"  data-sectionid=\"24\"  data-reqmsg=\"Event Description cannot be blank.\" aria-required=\"true\" data-invmsg=\"Event Description is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_26_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label id=\"field_3vwto_label\" class=\"frm_primary_label\" for=\"field_3vwto\">Planned date for co-sponsorship\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_3vwto\" name=\"item_meta[26]\" value=\"\"  data-sectionid=\"24\"  maxlength=\"10\" data-reqmsg=\"Planned date for co-sponsorship cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"  \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_14_container\" class=\"frm_form_field form-field  frm_required_field frm_hidden_container frm6\">\r\n    <div id=\"field_rbzd_label\" class=\"frm_primary_label\" for=\"field_rbzd\">Event Time\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_time_wrap\"><span dir=\"ltr\">\r\n<select aria-label=\"Event Time ... hour\" name=\"item_meta[14][H]\" id=\"field_rbzd_H\"  data-sectionid=\"24\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;,&quot;s&quot;:&quot;&quot;,&quot;ms&quot;:&quot;&quot;}\" data-reqmsg=\"Event Time cannot be blank.\" aria-required=\"true\" data-invmsg=\"Time is invalid\" class=\"auto_width frm_time_select\" aria-invalid=\"false\"  ><option value=\"\"  selected='selected'><\/option><option value=\"12\" >12<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><\/select>\r\n<span class=\"frm_time_sep\" aria-hidden=\"true\">:<\/span>\r\n<select aria-label=\"Event Time ... minute\" name=\"item_meta[14][m]\" id=\"field_rbzd_m\"  data-sectionid=\"24\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;,&quot;s&quot;:&quot;&quot;,&quot;ms&quot;:&quot;&quot;}\" data-reqmsg=\"Event Time cannot be blank.\" aria-required=\"true\" data-invmsg=\"Time is invalid\" class=\"auto_width frm_time_select auto_width frm_time_select\" aria-invalid=\"false\"  ><option value=\"\"  selected='selected'><\/option><option value=\"00\" >00<\/option><option value=\"30\" >30<\/option><\/select>\r\n<\/span>\r\n<select aria-label=\"Event Time\" name=\"item_meta[14][A]\" id=\"field_rbzd_A\"  data-sectionid=\"24\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;,&quot;s&quot;:&quot;&quot;,&quot;ms&quot;:&quot;&quot;}\" data-reqmsg=\"Event Time cannot be blank.\" aria-required=\"true\" data-invmsg=\"Time is invalid\" class=\"auto_width frm_time_select auto_width frm_time_select auto_width frm_time_select\" aria-invalid=\"false\"  ><option value=\"AM\" >AM<\/option><option value=\"PM\" >PM<\/option><\/select>\r\n<\/div>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_27_container\" class=\"frm_form_field frm_section_heading form-field \">\r\n<h3 class=\"frm_pos_top\">If Outreach Presentation:<\/h3>\r\n<div id=\"frm_desc_field_lzpsp\" class=\"frm_description frm_section_spacing\">Please fill out the information below to let us know about the desired date and time for the outreach presentation, and who you are seeking outreach from.<\/div>\r\n\r\n<div id=\"frm_field_29_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label id=\"field_ggfhe_label\" class=\"frm_primary_label\" for=\"field_ggfhe\">Preferred date for the outreach presentation\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_ggfhe\" name=\"item_meta[29]\" value=\"\"  data-sectionid=\"27\"  maxlength=\"10\" data-reqmsg=\"Preferred date for the outreach presentation cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_ggfhe\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_ggfhe\">ideally 3 to 4 weeks notice<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_31_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <div id=\"field_u01h0_label\" class=\"frm_primary_label\" for=\"field_u01h0\">Time\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_time_wrap\"><span dir=\"ltr\">\r\n<select aria-label=\"Time ... hour\" name=\"item_meta[31][H]\" id=\"field_u01h0_H\"  data-sectionid=\"27\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;,&quot;s&quot;:&quot;&quot;,&quot;ms&quot;:&quot;&quot;}\" data-reqmsg=\"Time cannot be blank.\" aria-required=\"true\" data-invmsg=\"Time is invalid\" class=\"auto_width frm_time_select\" aria-invalid=\"false\"  ><option value=\"\"  selected='selected'><\/option><option value=\"12\" >12<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><\/select>\r\n<span class=\"frm_time_sep\" aria-hidden=\"true\">:<\/span>\r\n<select aria-label=\"Time ... minute\" name=\"item_meta[31][m]\" id=\"field_u01h0_m\"  data-sectionid=\"27\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;,&quot;s&quot;:&quot;&quot;,&quot;ms&quot;:&quot;&quot;}\" data-reqmsg=\"Time cannot be blank.\" aria-required=\"true\" data-invmsg=\"Time is invalid\" class=\"auto_width frm_time_select auto_width frm_time_select\" aria-invalid=\"false\"  ><option value=\"\"  selected='selected'><\/option><option value=\"00\" >00<\/option><option value=\"30\" >30<\/option><\/select>\r\n<\/span>\r\n<select aria-label=\"Time\" name=\"item_meta[31][A]\" id=\"field_u01h0_A\"  data-sectionid=\"27\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;,&quot;s&quot;:&quot;&quot;,&quot;ms&quot;:&quot;&quot;}\" data-reqmsg=\"Time cannot be blank.\" aria-required=\"true\" data-invmsg=\"Time is invalid\" class=\"auto_width frm_time_select auto_width frm_time_select auto_width frm_time_select\" aria-invalid=\"false\"  ><option value=\"AM\" >AM<\/option><option value=\"PM\" >PM<\/option><\/select>\r\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_30_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6 frm_first\">\r\n    <label id=\"field_mpcas_label\" class=\"frm_primary_label\" for=\"field_mpcas\">Additional date option for the outreach presentation if your preferred date does not work for our team.\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"text\" id=\"field_mpcas\" name=\"item_meta[30]\" value=\"\"  data-sectionid=\"27\"  maxlength=\"10\" data-reqmsg=\"Additional date option for the outreach presentation if your preferred date does not work for our team. cannot be blank.\" aria-required=\"true\" data-invmsg=\"Date is invalid\" class=\"frm_date\" aria-invalid=\"false\"   aria-describedby=\"frm_desc_field_mpcas\"\/>\r\n    <div class=\"frm_description\" id=\"frm_desc_field_mpcas\">ideally 3 to 4 weeks notice<\/div>\r\n    \r\n<\/div>\n<div id=\"frm_field_32_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container frm6\">\r\n    <div id=\"field_vb65j_label\" class=\"frm_primary_label\" for=\"field_vb65j\">Time\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/div>\r\n    <div class=\"frm_time_wrap\"><span dir=\"ltr\">\r\n<select aria-label=\"Time ... hour\" name=\"item_meta[32][H]\" id=\"field_vb65j_H\"  data-sectionid=\"27\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;,&quot;s&quot;:&quot;&quot;,&quot;ms&quot;:&quot;&quot;}\" data-reqmsg=\"Time cannot be blank.\" aria-required=\"true\" data-invmsg=\"Time is invalid\" class=\"auto_width frm_time_select\" aria-invalid=\"false\"  ><option value=\"\"  selected='selected'><\/option><option value=\"12\" >12<\/option><option value=\"1\" >1<\/option><option value=\"2\" >2<\/option><option value=\"3\" >3<\/option><option value=\"4\" >4<\/option><option value=\"5\" >5<\/option><option value=\"6\" >6<\/option><option value=\"7\" >7<\/option><option value=\"8\" >8<\/option><option value=\"9\" >9<\/option><option value=\"10\" >10<\/option><option value=\"11\" >11<\/option><\/select>\r\n<span class=\"frm_time_sep\" aria-hidden=\"true\">:<\/span>\r\n<select aria-label=\"Time ... minute\" name=\"item_meta[32][m]\" id=\"field_vb65j_m\"  data-sectionid=\"27\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;,&quot;s&quot;:&quot;&quot;,&quot;ms&quot;:&quot;&quot;}\" data-reqmsg=\"Time cannot be blank.\" aria-required=\"true\" data-invmsg=\"Time is invalid\" class=\"auto_width frm_time_select auto_width frm_time_select\" aria-invalid=\"false\"  ><option value=\"\"  selected='selected'><\/option><option value=\"00\" >00<\/option><option value=\"30\" >30<\/option><\/select>\r\n<\/span>\r\n<select aria-label=\"Time\" name=\"item_meta[32][A]\" id=\"field_vb65j_A\"  data-sectionid=\"27\"  data-frmval=\"{&quot;H&quot;:&quot;&quot;,&quot;m&quot;:&quot;&quot;,&quot;A&quot;:&quot;&quot;,&quot;s&quot;:&quot;&quot;,&quot;ms&quot;:&quot;&quot;}\" data-reqmsg=\"Time cannot be blank.\" aria-required=\"true\" data-invmsg=\"Time is invalid\" class=\"auto_width frm_time_select auto_width frm_time_select auto_width frm_time_select\" aria-invalid=\"false\"  ><option value=\"AM\" >AM<\/option><option value=\"PM\" >PM<\/option><\/select>\r\n<\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_33_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label id=\"field_yf0ug_label\" class=\"frm_primary_label\" for=\"field_yf0ug\">Where on campus is this event occurring? (Room, building, or residence hall)\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input  type=\"text\" id=\"field_yf0ug\" name=\"item_meta[33]\" value=\"\"  data-sectionid=\"27\"  data-reqmsg=\"Where on campus is this event occurring? (Room, building, or residence hall) cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   \/>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_34_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label id=\"field_55qgm_label\" class=\"frm_primary_label\" for=\"field_55qgm\">Who are you requesting outreach from?\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[34]\" id=\"field_55qgm\"  data-sectionid=\"27\"  data-reqmsg=\"Who are you requesting outreach from? cannot be blank.\" aria-required=\"true\" data-invmsg=\"Who are you requesting outreach from? is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"\" selected='selected'> <\/option><option  value=\"Counseling Services\">Counseling Services<\/option><option  value=\"ENHANCE\">ENHANCE<\/option><option  value=\"Health Promotion\">Health Promotion<\/option><option  value=\"Wellness Is Now Peer Educators\">Wellness Is Now Peer Educators<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_35_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label id=\"field_f9kg4_label\" class=\"frm_primary_label\" for=\"field_f9kg4\">Outreach presentation options for Counseling Services\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[35]\" id=\"field_f9kg4\"  data-sectionid=\"27\"  data-reqmsg=\"Outreach presentation options for Counseling Services cannot be blank.\" aria-required=\"true\" data-invmsg=\"Outreach presentation options for Counseling Services is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"\" selected='selected'> <\/option><option  value=\"Who You Gonna Call? Overview of Referral and Emergency Criteria for Counseling Services\">Who You Gonna Call? Overview of Referral and Emergency Criteria for Counseling Services<\/option><option  value=\"Mental Health and Multicultural Issues\">Mental Health and Multicultural Issues<\/option><option  value=\"Imposter Syndrome\">Imposter Syndrome<\/option><option  value=\"Handling Anxiety using ACT (Acceptance and Commitment Therapy)\">Handling Anxiety using ACT (Acceptance and Commitment Therapy)<\/option><option  value=\"Tapping Away Anxiety using EFT (Emotional Freedom Technique)\">Tapping Away Anxiety using EFT (Emotional Freedom Technique)<\/option><option  value=\"Self-Esteem and Body Image\">Self-Esteem and Body Image<\/option><option  value=\"Managing and Coping with Stress\">Managing and Coping with Stress<\/option><option  value=\"Coping with Loss\">Coping with Loss<\/option><option  value=\"Campus Connect \u2013 A Suicide Prevention Training for Gatekeepers\">Campus Connect \u2013 A Suicide Prevention Training for Gatekeepers<\/option><option  value=\"Signs and Symptoms of Suicide\">Signs and Symptoms of Suicide<\/option><option  value=\"Current Trends in College Student Mental Health\">Current Trends in College Student Mental Health<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_36_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label id=\"field_155hg_label\" class=\"frm_primary_label\" for=\"field_155hg\">Outreach presentation options for ENHANCE\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[36]\" id=\"field_155hg\"  data-sectionid=\"27\"  data-reqmsg=\"Outreach presentation options for ENHANCE cannot be blank.\" aria-required=\"true\" data-invmsg=\"Outreach presentation options for ENHANCE is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"\" selected='selected'> <\/option><option  value=\"Orientation to the ENHANCE Program\">Orientation to the ENHANCE Program<\/option><option  value=\"Autism Spectrum Disorder Education\">Autism Spectrum Disorder Education<\/option><option  value=\"How to Best Work with Autistic Students\">How to Best Work with Autistic Students<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_37_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label id=\"field_m355_label\" class=\"frm_primary_label\" for=\"field_m355\">Outreach presentation options for Health Promotion\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[37]\" id=\"field_m355\"  data-sectionid=\"27\"  data-reqmsg=\"Outreach presentation options for Health Promotion cannot be blank.\" aria-required=\"true\" data-invmsg=\"Outreach presentation options for Health Promotion is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"\" selected='selected'> <\/option><option  value=\"Narcan Training\">Narcan Training<\/option><option  value=\"Mental Health First Aid\">Mental Health First Aid<\/option><option  value=\"Mindfulness and Meditation\">Mindfulness and Meditation<\/option><option  value=\"The Truth and Lies of STI\u2019s\">The Truth and Lies of STI\u2019s<\/option><option  value=\"Contraceptive Confidential: What\u2019s Your Method?\">Contraceptive Confidential: What\u2019s Your Method?<\/option><option  value=\"Understanding the Menstrual Cycle\">Understanding the Menstrual Cycle<\/option><option  value=\"Sleep Hygiene\">Sleep Hygiene<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_47_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label id=\"field_5p434_label\" class=\"frm_primary_label\" for=\"field_5p434\">Outreach presentation options for Wellness Is Now Peer Educators\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    \t\t<select name=\"item_meta[47]\" id=\"field_5p434\"  data-sectionid=\"27\"  data-reqmsg=\"Outreach presentation options for Wellness Is Now Peer Educators cannot be blank.\" aria-required=\"true\" data-invmsg=\"Outreach presentation options for Wellness Is Now Peer Educators is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"\" selected='selected'> <\/option><option  value=\"Love Your Selfie\">Love Your Selfie<\/option><option  value=\"Stress: Finding the Balance\">Stress: Finding the Balance<\/option><option  value=\"Dealing with Depression\">Dealing with Depression<\/option><option  value=\"Sleep for Success\">Sleep for Success<\/option><option  value=\"The Healthy Love Party\">The Healthy Love Party<\/option>\t<\/select>\n\t\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_39_container\" class=\"frm_form_field form-field  frm_top_container frm12 frm_first\">\r\n    <label id=\"field_1hsdk_label\" class=\"frm_primary_label\" for=\"field_1hsdk\">To ensure that we are meeting the needs of your community with our programming, please share any details about your class, office, or student organization and any specific discussion topics you would like us to address. \r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[39]\" id=\"field_1hsdk\" rows=\"5\"  data-sectionid=\"27\"  data-invmsg=\"Paragraph is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_41_container\" class=\"frm_form_field form-field  frm_required_field frm_top_container\">\r\n    <label id=\"field_6sn3f_label\" class=\"frm_primary_label\" for=\"field_6sn3f\">How many participants do you expect?\r\n        <span class=\"frm_required\" aria-hidden=\"true\">*<\/span>\r\n    <\/label>\r\n    <input type=\"number\" id=\"field_6sn3f\" name=\"item_meta[41]\" value=\"\" data-sectionid=\"27\"  data-reqmsg=\"How many participants do you expect? cannot be blank.\" aria-required=\"true\" data-invmsg=\"Text is invalid\" aria-invalid=\"false\"   min=\"1\" max=\"100\" step=\"1\" \/>\r\n    \r\n    \r\n<\/div>\n<\/div>\n<div id=\"frm_field_42_container\" class=\"frm_form_field form-field  frm_top_container\">\r\n    <label id=\"field_cwsdb_label\" class=\"frm_primary_label\" for=\"field_cwsdb\">Anything else you'd like us to know?\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <textarea name=\"item_meta[42]\" id=\"field_cwsdb\" rows=\"5\"  data-invmsg=\"Paragraph is invalid\" aria-invalid=\"false\"  ><\/textarea>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_22_container\" class=\"frm_form_field form-field  frm_none_container\">\r\n    <label id=\"field_u0298_label\" class=\"frm_primary_label\" for=\"g-recaptcha-response\">Captcha\r\n        <span class=\"frm_required\" aria-hidden=\"true\"><\/span>\r\n    <\/label>\r\n    <div  id=\"field_u0298\" class=\"frm-g-recaptcha\" data-sitekey=\"6LcLSAkUAAAAAJjKKRs3gDlMiRQtsstKRYJpqVNz\" data-size=\"normal\" data-theme=\"light\"><\/div>\r\n    \r\n    \r\n<\/div>\n<div id=\"frm_field_43_container\" class=\"frm_form_field form-field \">\r\n\t<div class=\"frm_submit\">\r\n\r\n<button class=\"frm_button_submit frm_final_submit\" type=\"submit\"  formnovalidate=\"formnovalidate\">Submit<\/button>\r\n\r\n<\/div>\r\n<\/div>\n\t<input type=\"hidden\" name=\"item_key\" value=\"\" \/>\n\t\t\t<div id=\"frm_field_48_container\">\n\t\t\t<label for=\"field_tkxn6\" >\n\t\t\t\tIf you are human, leave this field blank.\t\t\t<\/label>\n\t\t\t<input  id=\"field_tkxn6\" type=\"text\" class=\"frm_form_field form-field frm_verify\" name=\"item_meta[48]\" value=\"\"  \/>\n\t\t<\/div>\n\t\t<input name=\"frm_state\" type=\"hidden\" value=\"uP4Wwd6SgZvQQ4RGF\/WKOGnGBCDv5MLH6AuZLi8chFXpmtcMRQxpkSdgklN62srA\" \/><\/div>\n<\/fieldset>\n<\/div>\n\n<p style=\"display: none !important;\" class=\"akismet-fields-container\" data-prefix=\"ak_\"><label>&#916;<textarea name=\"ak_hp_textarea\" cols=\"45\" rows=\"8\" maxlength=\"100\"><\/textarea><\/label><input type=\"hidden\" id=\"ak_js_1\" name=\"ak_js\" value=\"18\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><\/form>\n<\/div>\n\n<h4 style=\"text-align: justify\">Please note that the form above is not used for requests for individual appointments at Ramapo College Counseling Services or Ramapo Health Services (Valley Medical Group).<\/h4>\n<p>To schedule an appointment with <a href=\"https:\/\/www.ramapo.edu\/counseling\/\">Counseling Services<\/a>, please contact: 201-684-7522.<\/p>\n<p>To schedule an appointment with <a href=\"https:\/\/www.valleyhealth.com\/ramapo-college-health-services\">Health Services (Valley Medical Group)<\/a>, please contact: 201-684-7536.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Outreach and Education from the Center for Student Wellness Thank you for your interest in partnering with the Center for Student Wellness for an outreach presentation or co-sponsorship. Outreach presentations\u00a0are when a representative from the Center for Student Wellness comes to your class, club, or organization for an engaging and educational presentation. Co-sponsorship requests refer [&hellip;]<\/p>\n","protected":false},"author":897,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-8","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v21.5 (Yoast SEO v27.1.1) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Outreach Request Form - Health Promotion || Ramapo College of New Jersey<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.ramapo.edu\/health-promotion\/outreach-request-form\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Outreach Request Form\" \/>\n<meta property=\"og:description\" content=\"Outreach and Education from the Center for Student Wellness Thank you for your interest in partnering with the Center for Student Wellness for an outreach presentation or co-sponsorship. 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