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Custom Programs Request Form
Please enter your full name.
Please enter your e-mail address.
Please enter your telephone number.
Please select your group type from the list.
Name of Group/Organization:
Please enter the name of your department, organization, residence hall, fraternity, sorority, or academic course.
Desired Date/Time of Event:
Please select your desired date/time for this event. Please not that due to scheduling conflicts, this date may need to change. Date/time confirmation will be sent in an e-mail at a later time.
Please select a second date/time choice in case your first choice is not available.
Select A Program:
Wellness: Party Like A Pirate
Wellness: One Size Does Not Fit All
Wellness: Top 10 Ways to Stay Safe and Healthy at ECU
Wellness: Stressed? Who Isn't?
Wellness: Sex Bingo
Wellness: Is your Health in Jeopardy?
Wellness: Sex Jeopardy
Wellness: Before the Lights Go Out - STDs
Wellness: Pills Patches and Rings Oh My - Methods of Contraception
Wellness: Can We Talk? Healthy Relationships and Communication
Wellness: Keep It Safe and Sexy (K.I.S.S.)
Wellness: Get Real - Straight Talk About Women's Health
Wellness: The Freshman 15
Wellness: Quit Now or Forever Hold Your Peace
Wellness: Get Real - Straight Talk about Men's Health
Physical Activity & Fitness: Improve Your Form in the Dorm
Physical Activity & Fitness: Fitness Area Orientation
Physical Activity & Fitness: Intro to Fitness
Intramurals: Intramural Challenge Games
Adventure: Custom Adventure Events
Adventure: Intro to Adventure
Team Training: Custom Challenge Course
Select the desired program from the list.
Build Your Own:
If you selected OTHER in the list above, please indicate the type of program you would like so that the appropriate person can be contacted.
Number of Participants:
Please indicate the location of the event.
Has your Coordinator approved this activity?
Please enter your Coordinator's name.
East Carolina University |
Campus Recreation & Wellness
128 Student Recreation Center | Greenville, NC 27858-4353
252.328.6387 | Fax: 252.328.6562 |
© 2013 |
| Last Updated: