Pre-lecture Form: Lecturers

Please use the form below or download the pdf.

* required

"*" indicates required fields

Lecturer's Name*

For Live Webinars

I am willing to have my webinar recorded by the Society and made available online
I would like to do a “test run” with the Society

For In-Person Lectures

Audio/visual equipment
I require the following equipment:

Travel Plans

Arrival

MM slash DD slash YYYY
Time*
:

Departure

MM slash DD slash YYYY
Time*
:

Contact Information

Additional lectures
Grades
This field is for validation purposes and should be left unchanged.

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