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Book a speaker

To book a speaker, please fill out the form below. We will get back to you as soon as possible.

First name:


Last name:


Street Address:

City, state, zip:

Daytime phone number:


E-mail address, if applicable:


Organization name:


Preferred topics. List of sample topics.



Speech date:


Speech time:


Location of event (Please include any building name if applicable, street address, city, state and zip code.)


Approximate size of audience:


Desired length of speech:

Is audio/visual equipment available? (Please check all that apply.)

Slide projector

Overhead projector

Computer with internet connection

Slide Screen


Will the speech be open to the public?

Yes

No

Directions/Special instructions:


Questions? Write to mary-kenyon@uiowa.edu