Guest Speaker Form | Spanish & Portuguese

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.