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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