Student Speakers Fund Application

Applying for support from the Student Speakers Fund is as easy as filling out this form. Please be sure to include all information before submitting this form:

A specific speaker, film, presenter, panel in mind
Estimates of how much such a production will cost
Another source of funding and how much you need from SSF
A date, time, and place for the event
A description of the topic and its relevance to the WPI community
A description of the presenter's knowledge of the topic and presentation skills
A summary of any and all costs associated with this event, including those not covered by the request

Contact E-mail address*
Contact Name*
*Contacts should be individuals who are willing to field questions from the committee and will be the only individuals who are contacted regarding this request.
Date of Application
Organization making the request
WPI Box Number
WPI Phone Number
Type of event	Lecture Panel Discussion Debate Film Other
If you selected "Other" type, please explain:
Name of lecturer, presenter, panelists, film, etc.
Date of Event
Time of Event
Location of Event
Requested Amount (generally limited to $500)
Has this event been scheduled with the Events Office?	Yes No
Will this event occur without Student Speakers Fund funding?	Yes No Unsure at this time
What other organizations/departments are contributing funding?
Please describe as completely as possible the topic to be presented and its relevance to the WPI Community:
Please provide relevant information and materials on the lecturer's knowledge of the topic area and presentation skills (send any relevant materials, résumés, brochures, letters, etc., to the Student Activities Office, Daniels Hall.)
Please describe as accurately as possible all costs related to producing this event, including those costs not covered by this request:
Are you willing to meet with the committee, should they have any questions regarding this event?	Yes No Maybe
How would you describe the targeted audience for this event?
If your request is granted, which account number would you like the money transferred to?
Type in the following two words

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Last modified: April 03, 2007 10:56:08