IVPI

Contact Info

Interpersonal Violence Prevention Initiative
Multicultural Center
Suite 209
Western Illinois University
1 University Circle
Macomb, IL 61455-1390
Phone: 309-298-2383
Fax: 309-298-2433
Email: ivpi@wiu.edu

Program/Presentation Request Form

Multicultural Center Suite 209
(309) 298-2383
facebook page

(XXX-XXX-XXXX)

Program/Presentation Topic (check all that apply):*



(please allow at least 2 weeks from date of request)

Program/Presentation length:*

Publicity will be done by:*


Room will be reserved by:*


Equipment will be reserved by:*


Requested Speaker (in addition to Interpersonal Violence Prevention Coordinator):*





(*) - Required Information