SPEAKER REQUEST FORM - to request funds for reimbursement of travel
expenses of visitors/speakers, send email with answers to these questions to
jal@ufl.edu (the visitors and colloquium committee chair, Jean Larson),<br>
deleenhe@ufl.edu (colloquium chair, Patrick DeLeenheer), and <br>
msomers@ufl.edu (Margaret Somers).  

The Visitors and Colloquium Committee will review your request 
and make a recommendation to the Chair of the
Department about funding.  

Today's date: 

Host's name: 

Speaker's name: 

Speaker's affiliation: 

Speaker's email address: 

Proposed dates of visit: 

Proposed date of colloquim talk(s), if any: 
(standard time is 4:05-4:55 on Mondays; you may propose two alternate dates)

Proposed date of seminar talk(s), if any: 

Purpose of visit: 
(research with host, interact with graduate students and/or faculty, etc.) 
giving a talk, interaction with my graduate students, discussion of future 
joint grant proposals)



Special circumstances, if any: 
(on sabbatical in USA, visiting family or colleagues in Florida, 
etc., coming for conference)



Amount requested and sources of funding:
**Departmental speakers budget: 
(max $700 colloquium only, max $400 speaker only, max $800 both)

**Grant:

**Other: 


 ___________ (yes no) I agree to the following Terms and conditions:

 1. I understand that most details of a speaker's visit, such as 
obtaining equipment necessary for the talk, picking up at airport, 
working with Margaret on hotel reservations, requesting an office 
for longer visitors, are coordinated by the host, and the host is
responsible for return of keys lent to the visitor.

 2.  If funds are made available, I will fill out the Visitor 
Information Form and give it to Margaret Somers a minimum of three 
weeks in advance of the visit.  I understand the department funds 
are for reimbursement of travel expenses only.

 3. It is the responsibility of the host to make sure that the 
visitor understands that a colloquium talk should be aimed in 
large part towards a general audience.  More technical or narrow 
talks may be more appropriate as seminar talks than as colloquia.

 4. Approval for this request cannot be transferred to a different 
time or different speaker without express approval from the 
colloquium chair and the fiscal assistant handling the colloquium 
moneys.