Is the Speaker Employed by the University? : *
Speaker Name: *
UHart ID number: *
Speaker Billing Address: *
Email Address: *
Multiple presentation dates can be submitted on one form. Be sure to state the dates and CRN's.
Course Title and CRN: *
Course Instructor(s): *
Date of Presentation: *
Length of Presentation: *
Compensation Rate: *
Compensation Rate = $60.00 per hour or $1.00 per minute