|
Event Sponsors |
|
|
Host |
|
|
Event Topic |
|
|
Presentation Title |
|
|
Probable Location of Event |
|
| |
|
|
Presenter * |
|
|
Presenter's Address * |
|
|
Presenter's Telephone |
|
| |
|
|
Presenter's Background/Vita |
|
| |
|
|
Date(s) of the event * |
|
| |
|
| How
will this event benefit the campus community? |
|
| |
|
|
Will the speaker be willing to visit classes? |
Yes
No |
| |
|
| If
yes, which classes? |
|
| |
|
Will the speaker have
meals with select groups? |
Yes
No |
| |
|
| If
yes, which groups? |
|
| |
|
|
Explain how this
event emphasizes the liberal arts goals of Monmouth College. See
http://www.monm.edu/aboutus/mission.htm for the narrative
about our mission and goals with particular attention to the
statement of purpose. |
|
|
| |
|
|
Explain how this
event has a multidisciplinary or interdisciplinary appeal.
Please list departments, majors, and events that would provide
the audience for this event, and the contact person in each
department, major, or event. |
|
Contact Person 1 |
|
|
Departments,
majors, or events 1 |
|
|
| |
|
|
Contact Person 2 |
|
|
Departments,
majors, or events 2 |
|
|
| |
|
|
Contact Person 3 |
|
|
Departments,
majors, or events 3 |
|
|
| |
|
|
Contact Person 4 |
|
|
Departments,
majors, or events 4 |
|
|
| |
|
|
Has this
presenter(s) or a similar event been
funded in the past?
|
Yes
No |
| |
|
|
If
so, when? |
|
| |
|
|
Please comment on the participation and quality of the
presentation from the previous event.
If there are supplementary
materials (pamphlets, vitas, etc) regarding this presenter(s),
please contact Karen Ogorzalek or the PAC chair. If there is a
website with additional information, please provide a web
address. For requests at or over $2500, supplementary materials
are required. |
|
|
| |
|
|
How will you
publicize this event? Sponsors and/ or hosts of funded events
must contact Jeff Rankin for information and assistance regarding
publicity. |
|
|
| |
|
|
Is there any
additional information that may be useful to the Public Affairs
Committee? |
|
|
| |
|
|
Local Travel
Arrangements |
| Who
will provide ground transportation? |
|
|
Phone Number |
|
| |
|
| To
and from the airport? |
|
|
Phone Number |
|
| |
|
|
During the visit? |
|
|
Phone Number |
|
| |
|
|
Budget |
|
Will you need a campus car? |
Yes
No |
| |
|
|
Honorarium |
|
| |
|
|
Travel |
|
| |
|
|
Meals On-campus
(indicate # of meal tickets needed) |
|
Breakfast, $3.75 |
|
|
Lunch, $5.25 |
|
|
Dinner, $6.00 |
|
|
Off-campus |
|
| |
|
|
Housing arrangements |
|
Number of Nights |
|
|
Price Per Night ($60 The Manor/roughly $80 for motels) |
|
|
Total for Housing |
|
| |
|
|
Other expenses (please list) |
|
| |
|
|
Subtotaled Cost |
|
| |
|
|
Funding from
other sources
(please list other sources
for each amount) |
|
| |
|
|
Total Amount Request |
|
| |
|
|
Karen Ogorzalek’s
office will coordinate travel plans and local hotel
accommodations.
***Please PRINT
the results page that you will see after clicking Submit!*** |
