JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Request Guest Speaker
To request a guest speaker from the Employee Ownership Speakers Bureau, submit this form.
Sign in to Google
to save your progress.
Learn more
Do you have a preferred guest speaker?
Yes
No
I'd like to get your input
Clear selection
If yes, which individual(s) do you request?
Your answer
Preferred date and time (please submit request at least a month in advance *if possible*)
Your answer
Alternate date(s) and time(s)
Your answer
Length of presentation
Your answer
What would you like the speaker to talk about? What do you want your students to learn? Do you have preferences re: format (e.g., lecture, discussion, or combination)?
Your answer
Name of class
Your answer
Name of department and university
Your answer
Number of students
Your answer
Any other notes / questions / requests?
Your answer
Your name and email address
Your answer
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Report Abuse
-
Terms of Service
-
Privacy Policy
Forms
