{"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":"2025-06-11T13:06:23","modified_gmt":"2025-06-11T17:06:23","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":"<h3 style=\"text-align: center\">Outreach and Education from the Center for Health and Counseling Services<\/h3>\n<p>Thank you for your interest in partnering with the Center for Health and Counseling Services for an outreach event or co-sponsorship.<\/p>\n<ul>\n<li>Outreach events are when a representative from Counseling Services, Health Services, or Wellness Is Now comes to your class, club, or organization for an engaging and educational event.<\/li>\n<li>Co-sponsorship requests 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 Services could co-sponsor a Blood Drive on campus.<\/li>\n<\/ul>\n<h4 style=\"text-align: center\">Wellness Is Now Peer Educators<\/h4>\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>\n<div id=\"frm_radio_450-0\" class=\"frm_radio\"><label for=\"field_hl39v-0\">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.<\/label><label for=\"field_hl39v-2\"><br \/>\n<\/label><\/div>\n<\/li>\n<li>\n<div id=\"frm_radio_450-0\" class=\"frm_radio\"><label for=\"field_hl39v-2\"><\/label><label for=\"field_hl39v-3\">Stress: Finding the Balance\u00a0<label for=\"field_hl39v-0\">\u2014<\/label>\u00a0Participants 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.<br \/>\n<\/label><\/div>\n<\/li>\n<li>\n<div id=\"frm_radio_450-0\" class=\"frm_radio\"><label for=\"field_hl39v-3\"><\/label><label for=\"field_hl39v-4\">Dealing with Depression\u00a0<label for=\"field_hl39v-0\">\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.<br \/>\n<\/label><\/label><\/div>\n<\/li>\n<li>Just Keep Breathing\u00a0<label for=\"field_hl39v-4\"><label for=\"field_hl39v-0\">\u2014 In this anxiety-centered outreach event, students will discuss their anxiety triggers and a variety of interventions they can implement to breathe through it.\u00a0<\/label><\/label><\/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<h4 style=\"text-align: center\">DON&#8217;T CANCEL THAT CLASS\/MEETING!<\/h4>\n<p>Counseling and Health Services 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<p>To ensure equity and inclusion with our programming, the needs of various populations and student groups will be met through tailored and targeted discussions during the workshop. Please indicate in the form below any details necessary to assist us in this aim.<\/p>\n<h4 style=\"text-align: justify\">Please note that the form below is for requesting presentations for your club or group only. It is not used for requests for individual appointments at Counseling or Health Services.<\/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.ramapo.edu\/health\/\">Health Services<\/a>, please contact: 201-684-7536.<\/p>\n<h3 style=\"text-align: center\">Outreach, Education and Cosponsorship Request Form<\/h3>\n<p>Outreach requests will be evaluated on a case by case basis. Please give as much advance notice as possible, preferably 3 weeks notice. Please fill out the fields below, click &#8220;submit,&#8221; and someone will be in touch with you as soon as possible. If you have any questions, please email studentwellness@ramapo.edu for Health and Counseling Services requests and win@ramapo.edu for Wellness Is Now requests.<\/p>\n<p><strong>Different outreach events are available from Counseling Services, Health Services, and Wellness Is Now. Please complete the form for the correct group you are seeking outreach from.<\/strong><\/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=\"3b46eb7f09d5f8eea2e73c653e61f9be\">\n<form enctype=\"multipart\/form-data\" method=\"post\" class=\"frm-show-form  frm_pro_form \" id=\"form_outreach-fork\" data-token=\"3b46eb7f09d5f8eea2e73c653e61f9be\">\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=\"17021d9b31\" \/><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 outreach from CHCS staff\/peer educators?\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 outreach from CHCS staff\/peer educators? cannot be blank.\" data-invmsg=\"Are you requesting co-sponsorship for an event or outreach from CHCS staff\/peer educators? 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 from CHCS staff or WIN Peer Educators\"\n\t\t data-reqmsg=\"Are you requesting co-sponsorship for an event or outreach from CHCS staff\/peer educators? cannot be blank.\" data-invmsg=\"Are you requesting co-sponsorship for an event or outreach from CHCS staff\/peer educators? is invalid\"   \/> Outreach from CHCS staff or WIN Peer Educators<\/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 co-sponsorship for? Please provide content, date, time, who you are requesting co-sponsorship from in CHCS, and how we can help with co-sponsorship (marketing, attendance, 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_top_container frm6 frm_first\">\r\n    <label id=\"field_3vwto_label\" class=\"frm_primary_label\" for=\"field_3vwto\">Date\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-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_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-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-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-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:<\/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 event, 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\">Date of outreach 1\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=\"Date of outreach 1 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_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-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-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-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_top_container frm6 frm_first\">\r\n    <label id=\"field_mpcas_label\" class=\"frm_primary_label\" for=\"field_mpcas\">Date of outreach 2\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-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_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-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-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-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_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\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-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_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-invmsg=\"Who are you requesting outreach from? is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"\" selected='selected'> <\/option><option  value=\"Counseling\">Counseling<\/option><option  value=\"Health\">Health<\/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_top_container\">\r\n    <label id=\"field_f9kg4_label\" class=\"frm_primary_label\" for=\"field_f9kg4\">Outreach presentation options for Counseling\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-invmsg=\"Outreach presentation options for Counseling is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"\" selected='selected'> <\/option><option  value=\"Mental Health and Cultural Diversity Issues\">Mental Health and Cultural Diversity Issues<\/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><option  value=\"Neurodiversity IS Diversity\">Neurodiversity IS Diversity<\/option><option  value=\"Racial Trauma\">Racial Trauma<\/option><option  value=\"Racial Battle Fatigue\">Racial Battle Fatigue<\/option><option  value=\"Imposter Syndrome and BIPOC Students\">Imposter Syndrome and BIPOC Students<\/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, Body Image and Stress Management\">Self-Esteem, Body Image and Stress Management<\/option><option  value=\"Managing and Coping with Stress for Transfer Students\">Managing and Coping with Stress for Transfer Students<\/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><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>\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_top_container\">\r\n    <label id=\"field_155hg_label\" class=\"frm_primary_label\" for=\"field_155hg\">Outreach presentation options for Health Services\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-invmsg=\"Outreach presentation options for Health Services is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"\" selected='selected'> <\/option><option  value=\"The Truth and Lies of STI\u2019s\">The Truth and Lies of STI\u2019s<\/option><option  value=\"Fighting the Common Cold (and other Viruses)\">Fighting the Common Cold (and other Viruses)<\/option><option  value=\"Medical Care after a Sexual Assault\">Medical Care after a Sexual Assault<\/option><option  value=\"Sleep Hygiene\">Sleep Hygiene<\/option><option  value=\"Understanding the Menstrual Cycle\">Understanding the Menstrual Cycle<\/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_top_container\">\r\n    <label id=\"field_m355_label\" class=\"frm_primary_label\" for=\"field_m355\">Outreach presentation options for Wellness is Now\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-invmsg=\"Outreach presentation options for Wellness is Now is invalid\" aria-invalid=\"false\"  >\n\t\t<option  value=\"\" selected='selected'> <\/option><option  value=\"Love Your Selfie\">Love Your Selfie<\/option><option  value=\"My Mind and Me\">My Mind and Me<\/option><option  value=\"You\u2019re Not You When You\u2019re Hangry\">You\u2019re Not You When You\u2019re Hangry<\/option><option  value=\"Stress: Finding the Balance\">Stress: Finding the Balance<\/option><option  value=\"Dealing with Depression\">Dealing with Depression<\/option><option  value=\"Just Keep Breathing\">Just Keep Breathing<\/option><option  value=\"The Healthy Love Party (with the V.I.P.&#039;s)\">The Healthy Love Party (with the V.I.P.&#039;s)<\/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\">Based on your workshop selection, please provide any context or details that will be important for us to know in planning this event:\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    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type=\"hidden\" id=\"ak_js_1\" name=\"ak_js\" value=\"16\"\/><script>document.getElementById( \"ak_js_1\" ).setAttribute( \"value\", ( new Date() ).getTime() );<\/script><\/p><\/form>\n<\/div>\n\n","protected":false},"excerpt":{"rendered":"<p>Outreach and Education from the Center for Health and Counseling Services Thank you for your interest in partnering with the Center for Health and Counseling Services for an outreach event or co-sponsorship. Outreach events are when a representative from Counseling Services, Health Services, or Wellness Is Now comes to your class, club, or organization for [&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 Health and Counseling Services Thank you for your interest in partnering with the Center for Health and Counseling Services for an outreach event or co-sponsorship. 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