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Guest Speaker Form
Guest Speaker Form
Event Name
Event Date(s)
Faculty Organizer
Guest Speaker Name
Guest Speaker Email
Funds Requested for:
Covering (depending on funding):
Honorarium
Airfare/mileage
Hotel
Taxi/subway/bus
Meals (per diem)
Incidentals (baggage, etc)
Faculty Club Meal
Honorarium Amount (if applicable):
Preferred Hotel Location (if applicable):
Event is Covering These Meals (if applicable):
Date of Faculty Club Meal (if applicable):
# of People for Faculty Club Meal (if applicable):
Please note the rule of 4 university people: 1 guest speaker ratio.
Who is Attending Faculty Club Meal (if applicable):
Funding Source
Please list at least one source of funding; include the Department, Amount, and Contact Person.
Are you asking for contributions from other departments?
If so, please include the Department, Amount, and Contact Person.
Leave this field blank
Submit