Colloquium/Seminar Request Form

Colloquium/Seminar Request Form

Host First Name*

Host Last Name*

Speaker First Name*

Speaker Last Name*

Speaker Email Address*

Affiliation/Institution*

Preferred Job Title*

Reason for Visit*

Select or enter value

Please explain nature of visit.*

Will this be virtual?*

Select

Please use link below to reserve your desired date. Once you've chosen your date in the next window, return to this tab for the form, record your reserved date in the field below and press submit.*

https://calendar.app.google/xGbfw2QSDaTcQ6tK6

If you do not wish to choose from the regular Thursday 1pm seminar dates, please list your requested date and time in the same calendar field box below.

Financials

What costs will DCB cover for this seminar?*

Options include: Speaker Travel, Hotel, Lunch with Speaker, Dinner with Speaker etc. Please list all that apply.

Which account will cover costs for this seminar?*

Select or enter value

Please list the account(s) that will be charged*

Acknowledgement of Financial Responsibility*

There is a maximum budget of $660 for ALL expenses associated with this speaker that are charged to the department colloquium account. That includes all travel costs of the speaker, hotel stay, lunch with the speaker and dinner with the speaker. Anything spent by the faculty host OR the speaker over that amount will be the responsibility of the faculty host. It is up to the host to decide whether they want to limit the amount the speaker can be reimbursed or if they want to let the traveler be fully reimbursed and cover the potential overflow cost with their personal unrestricted funds. Cost per speaker ranges anywhere from $300 to $1800 depending on many situational factors. The average cost of a 2-day speaker hotel stay is $376.84, the average cost of airfare is $500, the average cost of lunch with 3 people (speaker and 2 students) is $120 and the average cost of dinner with 3 people (speaker and 2 faculty) is $200.

Please check the box below to acknowledge that you have read the statement above and you are assuming financial responsibility as the faculty host if the seminar cost is over $660.

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