Request for AHEC Program

Please fill in all fields below. If you would like to request a program not listed in our catalogue or have a suggestion for a possible program please feel free to contact Annie Taft at (919) 966-3736 or email ataft@email.unc.edu.

Requesting AHEC:
Person requesting program(s):
Select the program. If you'd like to request multiple programs, hold down the CONTROL key and click the desired programs with your mouse.
Possible dates for program:
Possible location for program:
Length of program:
Special Request (if any)