Department Workshop Request Form

Planning a Benefits & Worklife Workshop for Your Department

Please complete this form if you would like to request a workshop from the Office of Benefits & Worklife. Please complete a separate form for each workshop or class requested, at least one month in advance.

*This form should not be used for crisis support.*

For crisis response, contact the Employee Assistance Program (JHEAP) directly at 888-978-1262 or email at [email protected].

Requester Information

Name(Required)

First Last

Department(Required)

Phone(Required)

Email(Required)

Event Information

Event Name(Required)

Event Address

City State Zip

Event Date: ( If you do not have a specific date please list preferred month, day of the week and time of day)(Required)

Start Time

End Time

Number of Attendees Expected

Choose one workshop topic:(Required)

JHU Benefits Overview

Family and Caregiving Programs

Mental Health / Johns Hopkins Employee Assistance Program (JHEAP)

JHU Retirement Planning

JHU Well-being Program

JHU Work Life Programs

Please complete a separate form for each workshop requested.

Event Description(Required)

Please provide reason for request and as many details as possible. List onsite contact and phone if different from above.

Event Details

Who is attending?(Required)

Staff

Managers/Supervisors

Faculty

Support Staff

JHU Employees

JHH/JHHS Employees

Post-doctoral Fellows

House Staff

Type of Event(Required)

Staff Meeting

In-service Training

Retreat

Other

Please specify "Other" if selected

Delivery Format(Required)

In-person

Virtual

Hybrid

If in-person, provide parking details and any security/front desk check in instructions:

If virtual please select below:

We will provide the webinar link.

We would like the presenter to provide the webinar link.

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