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Colloquium Speaker Form
Please fill out if your colloquium speaker has any financial requests.
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* Indicates required question
Email
*
Your email
Your name
*
Your answer
Name of colloquium
*
Early Modern/Renaissance
Long 18th Century
Long 19th Century and Modernism/20th Century and Contemporary
Medieval
Race and Ethnicity
Theater and Performance
Is this event co-sponsored with another colloquium?
*
Yes
No
If yes, please list the other sponsoring colloquium/colloquia
Your answer
Name of speaker
*
Your answer
Email of speaker
*
Your answer
Is the speaker a US citizen?
*
Yes
No
Not sure
Is the speaker an alum of the PhD program?
*
Yes
No
Date of talk
*
MM
/
DD
/
YYYY
Time of talk
*
Time
:
AM
PM
Title of talk
*
Your answer
What is the maximum amount of reimbursement the colloquium is providing for your speaker's travel expenses? (Put $0 if you are not providing travel reimbursement.)
*
Your answer
What is the speaker's honorarium amount?
*
Your answer
Does your speaker need lodging?
*
Yes
No
Not sure
If your speaker needs lodging, please indicate which dates they need that the colloquium will be funding. Sol will be in touch with final reservation information. If you have a hotel preference, put that information here.
Your answer
Additional comments (if co-sponsoring with another colloquium, please give me breakdown of shared expenses here).
Your answer
A copy of your responses will be emailed to the address you provided.
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