JCA Program Request

Your Name:

Please enter your complete first and last name

Email address

Please enter a valid email address where we can contact you

Your phone number

Please enter your phone number including area code

Your UT or Knoxville affiliation

UT Department or outside of UT organization/business

Event Date:

Event Start Time

Event End Time

What program are you requesting?

Program Location

Classroom building/number, meeting room number, off campus address, etc.

How many people will be attending?

Tell us about your group

Is this for a class or organization? What is their year in school, gender, etc.?

Please check the stage pf group development your group is currently at based on Tuckman's Model of Group Development.

Forming: The group has been newly established and is still in the "getting to know you'' stage

Storming: A comfort level is being established and conflict may arise with the group

Norming: The group is becoming cohesive and is comfortable in freely sharing ideas

Performing: The group is productive, independent, and is both task and people oriented

Adjourning: The group is in its final stage and members are beginning to exit/graduate

N/A: This is an open event for all students and is thus not targeted at a specific group

Additional Information

Is there any additional information we should know about your group or the program location (special needs of the group, challenges, layout of space, etc.)?