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Dean Ashish K. Jha Speaker and Appearance Request Form
Thank you for your interest in having Dean Jha speak at your event. Please complete and submit the following form. We will aim to provide you a response within one week, although sometimes responses may take longer.
If you have any questions or need help completing the form, please reach out to
deanofpublichealth@brown.edu
.
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* Indicates required question
Event Name
*
Your answer
Date of Event
*
MM
/
DD
/
YYYY
Time
*
Time
:
AM
PM
Event Format
*
In-person
Virtual
Both
Event Location
Your answer
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