Please confirm the name of the speaker/talk you are trying to schedule *
Required
What is your first choice date for the speaker to come to your class(es)? *
MM
/
DD
/
YYYY
What is your second choice date for the speaker to come to your class(es)?
MM
/
DD
/
YYYY
What is your third choice date for the speaker to come to your class(es)?
MM
/
DD
/
YYYY
What time would you like the speaker to come to your class(es)? (Please indicate the start time for the first class section if requesting multiple presentations). *
Time
:
AM
PM
What age are your students? *
What is the course in which you'd like the speaker to present? *
Your answer
How many class sections would you like the speaker to address? *
Choose
one class section
two class sections
three class sections
four or more class sections
Approximately how many students will the speaker address? *
total for all requested class sections
Your answer
What will you provide for the speaker? Check all that apply. *
Required
Please check the boxes below to indicate that you agree to: *
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