Apply for Committee on Lectures Funding or Publicity Assistance

Lecture

Proposed event/speaker *

Topic/title of lecture *

Date

If date has been set

Location

Please include room name or number

Time

If time has been set

Planning Organization

Requesting organization(s) *

Student contact for the event email address *

Student contact for the event phone/cell number *

Faculty Advisor email address *

Faculty Advisor phone/cell number *

Brief bio (3-5 sentences) including important honors/awards, books authored, relevant previous positions, and academic degrees, if applicable. *

Possible benefits of the lecture to Iowa State students (3-5 sentences) *

Publicity Only

If you are not seeking funding for your event, but would like the Committee on Lectures to publicize your event, please indicate whether the unit you represent is hosting the event on their own account or will be using Lectures' account.

Cost of Lecture

Cost of honorarium * $

Cost of travel * $

Cost for lodging * $

Cost for meals * $

Event costs *

(For each event requesting funding and/or asking Lectures to manage the event, please include $500, which covers publicity, A/V and facilities fees, and captioning costs.)

Other funds required * $

Please describe funds if other funds are requested

TOTAL COST OF LECTURE * $

Please add the honorarium expenses, travel expenses, lodging expenses, meals, publicity, and other costs to find this number.

Funding Sources

Source 1 (note requested or confirmed) *

Source 1 amount * $

Source 2 (note requested or confirmed)

Source 2 amount $

Source 3 (note requested or confirmed)

Source 3 amount $

Source 4 (note requested or confirmed)

Source 4 amount $

Source 5 (note requested or confirmed)

Source 5 amount $

Additional funding sources

Please list funding sources not above

TOTAL amount requested from the Committee on Lectures * $

Subtract “Total other funding sources” from “Total cost of lecture”