Scheduling Request
Seminars & Colloquia

_____ On Campus Speaker (Please give information to Phyliss Ball)
_____ Off Campus Speaker (Please give information to Sandy Gary)

GROUP/CENTER:
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Speaker (Degree):
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University/Department: ______________________________________________________________

Email:
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Date & Time of Presentation:
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Location:
______________________________________________________________

Title of Presentation:
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Co-Sponsors (if any): _________________________________________________
_________________________________________________
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Funding from Co-Sponsors or Other Sources – List Funding Source & Amount from Each):

_________________________________________________
_________________________________________________
_________________________________________________
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Comments:
_________________________________________________
_________________________________________________
_________________________________________________
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Please feel free to call either Valarie (vblyden@uga.edu or 542-1806) or Sandy (sgary@uga.edu or 542-6100) if you need any assistance. You may Fax (542-6064) or email the above information.

* Seminars will be held in Room 106, Barrow Hall unless otherwise requested.