Name: Phone: Email: NEIU Department/Company/Organization (if applicable): Are you a: NEIU student NEIU Faculty/Instructor/Staff NEIU Student Organization Other… Enter other… Subject of workshop or training event: Subject of workshop or training event: - Select -Bystander InterventionSpeaker RequestOther… Enter other… Brief explanation of purpose of request: Date of requested event/workshop: Time of requested event/workshop: Submit