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Faculty Speakers Bureau

To be completed by Requesting Organization

Speaker Request Form
Name of organization
Contact person
 Street address
City, county, state
  Zip
Daytime phone number
E-mail Address
Speaking Event Information
 Requested speaker
Requested topic
Alternate speaker
Alternate topic
Alternate speaker
Alternate topic
Speech date
Speech time
Location of event
 Street address
City, county, state
  Zip
Length of presentation requested (in minutes)
Audience size
 Audiovisual equipment available?

yes, please specify

no

Comments/Questions

 

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Speakers Bureau

 

For additional information, call University Governance at (785) 864-5169,e-mail govern@ku.edu, or write the Faculty Speakers Bureau, The University of Kansas, University Governance, Strong Hall, 1450 Jayhawk Blvd., Room 33, Lawrence, KS 66045-7535