International VOICES - Speaker Request

Question 1

First Name:

Question 2

Last Name:

Question 3

Email Address:

Question 4

Phone Number:

Question 5

Local Address:

Question 6

School/Department/Organization:

Question 7

Course No. & Title (if applicable):

Question 8

Are you able to provide transportation to the presenter, if requested?

Yes
No

Question 9

Proposed Event Date (mm/dd/yyyy):

Question 10

Proposed Event Start Time:

Question 11

Proposed Event End Time:

Question 12

Proposed Event Name, Location, & Description:

Question 13

What countries or regions would you like represented?

Question 14

What is your proposed topic(s)?

Social & Cultural
Politics & Economy
Business Culture & Attire
Current Events
Historical Events
Foreign Relations
Personal Experience as an International Student
Religion & Faith
Other

Question 15

What is the desired format of the event?

Panel Discussion with Q&A
Formal Presentation by a single presenter
Formal Presentation by a group of presenters
Other

International VOICES - Speaker Request Form