Academic Assembly Program Proposal Form

1) Sponsoring committee or unit:
2) Program Title:
3) Contact Person:
Name:
Campus Address:
Phone:
Email:

4) Which of the following best describes the objective of this program?

If other, please explain:

5) Please write a brief description of your program:

6) Please describe how this topic is of interest and how it meets current needs:

7) Please specify target audience (and estimated audience size):

8) Program format:

If other, please explain:

9) Provide an outline of the program. Be sure to identify speakers' names.

10) Please give as complete an estimate as possible for the program.

Honorarium:
Travel:
Lodging:
Other speaker expenses (please specify):
Catering:
Handouts:
Room and audiovisual fees:
Total:

Completed forms must be submitted to the Academic Assembly Steering Committee.
Members for 2007-2008 Academic Year are:
Eric Acree, Michael Cook (secretary), Eileen Heeran, Anna Korhonen, and Lynn Thitchener (chair)

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rev. 11/6/00, ajc