Application for University Lectures
Program Support
Name of Applicant:
________________________________________________________________ Date: _____________________________________________________
College/School:
___________________________________________________________________ Department:
_______________________________________________
Name of Proposed Lecturer:
_________________________________________________________ Title:
______________________________________________________
Lecturer’s Address:
_________________________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________________________
Anticipated Dates of Lecture:
_________________________________________________________ Estimated Costs:
__________________________________________
Amount Requested from Lectures Fund:
__________________________________________________________________________________________________________
Amount
and Source of Other Funds:
___________________________________________________________________________________________________________
_______________________________________________________________________________________________________
________________________________________________________________________________________________________
Please address the following
questions in an attachment to this application form.
1. Provide
a description of the Lecturer’s work and contribution to his/her field;
highlight examples of distinctive scholarship and accomplishment. Attach a copy
of his/her vita.
2. Provide an explanation of the relative
contribution the proposed Lecturer would make to the instructional program
including the tentative topic for the formal presentation.
3. Anticipated
Schedule of Activities for Lectures Program.
4. Outline
the plans for publicizing the Lecturers Program.
5. Provide
a proposed budget with a breakdown of expenditures for the Lectures’ Program event,
including travel and lodging costs, meals, venue
rental
expense, publicity/printing costs, honorarium, and other miscellaneous
costs.
Approved:
______________________________________________________________ _____________________________________________________
Department Head Date
______________________________________________________________ _____________________________________________________
Dean Date
Return to:
Office of
Undergraduate Studies, Attention: Dr. Cavender, 129 Quad Center, Tel.844-4900.
.
Rev.10/07