Distinguished lecturer series — Online Application Form

Deadline: October 1, 2008

Please fill out this form completely. Fields marked with an asterisk (*) are required. All US colleges, universities and nonprofit organizations are eligible to apply.

Visit the Distinguished lecturer series area of the Ridge 2000 website.

Shortcut to get contact Information

Already a Ridge 2000 member? If so, just insert your username and password, click the 'Get contact info' button and we will retrieve your information for you. Otherwise complete the Contact Information fields below:

Username: Password:

Status: Awaiting event...

Contact Information

Name:*

Email:*

Phone:*

Fax:

Institution:*

Address:*

City:*

State:*

Zip:*

Requested Speakers

Speaker choices by order of preference
Learn about this years speakers (pop-up window)
(Note: list two choices to aid scheduling and increase your institution's chance of hosting a lecturer):

Speaker 1:*

Speaker 2:*

Lecture Type
Select the type of lecture that best suits your audience; you may select both.

Lecture Type:* Science Community
General Public

Host Information

Science Community Lecture Host

Host department / organization:*

Co-Host department / organization:

General Public Lecture Host

Host department / organization:*

Co-Host department / organization:

Host department / organization size:

Undergraduate Students:*

Graduate Students:*

Faculty / Professional Staff:*

Employees:*

Please list other departments / schools / organizations in the area that will be invited to both lecturers: 1.
2.
3.
4.
5.
6.

How did you hear about this program?

Please briefly describe your plan for publicizing each lecture: *

Please describe briefly how you plan to solicit traditionally
underrepresented audiences to the lecturers at your institution: *

Evaluation *

We are conducting an evaluation of the Distinguished Lecture Series in an effort to improve the series. We ask that hosts fill out an evalution form and administer evaluation forms to the audience at all lectures. Are you willing and able to administer evaluations?
NOTE: Forms will be provided by the Ridge 2000 Office.

Yes
No

Visit the Distinguished lecturer series area of the Ridge 2000 website.

Questions? Problems? Contact the Ridge 2000 office.