Humphrey Fellows Request Form 2017 - 2018
Your Name *
Your answer
Your Course Prefix, Number, and Section *
Ex. HLT 135 03PR
Your answer
Email *
Your answer
Best Phone Number *
Your answer
Humphrey Fellow(s) Requested *
Please identify the Fellow(s) that you would like to request for your class activity.
Required
Briefly describe your planned activity for the invited Fellow(s) *
Your answer
Date of Activity (First Choice) *
Select the date that best suits your course schedule for this activity.
MM
/
DD
/
YYYY
Date of Activity (Second Choice) *
Select a second date option, in case the Fellow is not available for your first choice.
MM
/
DD
/
YYYY
Class Start Time *
Time
:
Campus Location *
Classroom Number *
Your answer
Additional Comments or Questions
Your answer
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