Invited Speaker and Engagement Form

Invited Speaker and Engagement Form

Submitting Faculty Member Name*

Submitting Faculty Member Email*

Department Name*

Program Name*

First and Last Name of Invited Speaker*

Speaker Occupation or Industry*

Speaker Employer

Purpose of Engagement or Talk*

Is the Speaker an Alumni?*

Yes

No

Date of Engagment*

Time of Engagement*

Does the invited speaker need help getting from parking to your facility? If yes, please specify how we could help.

Where do you want the gift delivered and is there a best time to drop off?

Do you want this engagement passed on to the CLA marketing team for promotion?

Select or enter value

Send me a copy of my responses

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