Speakers Bureau Requests
Complete the form below to request a presentation by the Speakers Bureau during the Fall 2017 semester.
Requestor's first name *
Your answer
Requestor's last name *
Your answer
Email (where we will communicate about this request) *
Your answer
Course number AND section, for example, LGBT 350: 0101 (if not a course, enter NA) *
Your answer
Directory ID or UID of the course instructor (if not a course, enter NA) *
Your answer
If not a course, name of group
Your answer
Number of students enrolled in the course (or anticipated number of people attending the presentation if not a course) *
Your answer
Preferred date of presentation *
MM
/
DD
/
YYYY
Time presentation to begin *
Time
:
Time presentation to end (minimum of 45 minutes; maximum of 90 minutes) *
Time
:
Location of the presentation (on-campus locations must include building and room number, for example, WDS 1131 or Woods Hall 1131; off-campus locations must include the full street address) *
Your answer
How did you learn about Speakers Bureau? If a person referred you, please enter their name.
Your answer
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