Guest Speaker and Internship Supervisor Approval
Thank you for helping the Dean of Faculty office manage all of the University's Guest Speaker requests more orderly and efficiently.

~ This form should be used for all guests who will be in the classroom, will be publicly performing on campus, will serve as an Internship Supervisor, or other such activities.

~ If your applicant is a Trustee of the University or currently on faculty, they are already approved.

~ Guest Speakers must be re-approved every 6 months.

~ Guest Speakers are allowed in class for one to three days. If you plan to have them join your class longer than three days, please submit the Request Faculty Hire Form

Please fill out the Guest Speaker and Internship Supervisor Form for each guest speaker separately and wait for approval before proceeding with the event. Only faculty, staff, and students may fill out this form.

Guest speakers should be experts in their field and present material that is appropriate for the students to whom they are speaking.

You will hear from the Dean of Faculty's office within two weeks.

Name of Guest Speaker or Internship Supervisor
Your answer
Name of person making this request
Your answer
What are your requesting approval for?
Choose all that apply
Required
Website of Guest Speaker or Internship Supervisor
Your answer
Contact Information for Guest Speaker or Internship Supervisor
Your answer
Current Occupation of Guest Speaker or Internship Supervisor
Your answer
Type of Event
Date of Event
Your answer
Notes:
For an Internship, briefly describe the activities during the internship. For a Guest Speaker, briefly describe topics. Will the faculty be in the classroom with them? Please be brief.
Your answer
Movement Status of Guest Speaker or Internship Supervisor
If Meditator, please give name of instructor and date and location of instructror. If Sidha, Governor or Certified Governor, please give CIC and/or TTC and/or Refresher course date & location if available
N/A if Not Available
Your answer
Last 4 digits of SSN, if available.
Your answer
Who should be notified of approval status?
Include only the email of everyone who should be notified of approval. example@mum.edu, example@gmail.com
Your answer
Requester Department
Your answer
Approval/Denial Date
Office Use Only
Your answer
Events Planning
Visit our Events Planning website and make sure you have everything approved and in order for your event, reserving venue, A/V, etc.
www.mum.edu/events
Guest Speaker Policy
Each guest speaker must be re-approved every 6 months. As many guest speakers are requested multiple times throughout the year, this form will help us:
1) record who has been approved and the date of approval
2) who needs to be re-approved (which is by the faculty's request)
3) keep track of the applicant's information for the next approval process

If you have any questions please feel free to contact our office.

dof@mum.edu

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