Faculty Senate Speakers Bureau - Speaker Request Form

Request a Speaker

To request a speaker, please complete the form below. Required fields are marked in red.

To move your cursor into a field use the "Tab" key or click in the field using your mouse.

What happens after you fill out this form...

Once you complete this form, we will review the information about your event and contact the faculty member directly on your behalf. Please allow us 3-5 business days to conduct this correspondence. If we have questions or need to confirm information, we will contact you directly via phone or email. We look forward to working with you in scheduling your faculty speaker talk.

----- Contact Person Information ------
First Name
Last Name
City
State
Zip Code
Daytime phone
Email
Your Group's Name
Brief Description of your Group
----- Speaker Request Information ------
First Choice Speaker - Full Name
Second Choice Speaker - Full Name
Third Choice Speaker - Full Name
Fourth Choice Speaker - Full Name
Fifth Choice Speaker - Full Name
----- Details About the Talk -----
Type of Talk	Commonwealth Lecture for a civic or nonprofit group Alumni Association Lecture for a UVa alumni group Scholastic Enrichment Lecture for a youth or children's group
Date and Time
Alternate Date and Time
Second Alternate Date and Time
Talk Location
Comments

Speakers Bureau Information
About the UVa Faculty Senate Speakers Bureau
Help searching for a speaker
Becoming a speaker in the Faculty Senate Speakers Bureau

Testimonials
"Mary was fabulous -- she did a great job!"
"It was an excellent talk!"
"The meeting was a great hit and Professor Ribando did a wonderful job."

Did You Know?
Since 1999, over 50 UVa Faculty speakers have reached more than 2,500 people across Virginia and the U.S.

----- Contact Person Information ------

----- Speaker Request Information ------

----- Details About the Talk -----