External Speaker Form
Newcastle University Students' Union
Please Note:
If more than one speaker, please complete a separate form for each speaker
Name of Club/Society
*
How many people do you estimate will be attending the event?
*
Will you be inviting members of the public?
*
Yes
No
Where are you trying to book a room?
*
Zoom, Teams or other virtual platform
University
Students' Union
Name of Event
*
Event Date
*
-
Month
-
Day
Year
Date
Event Time
*
Hour Minutes
AM
PM
AM/PM Option
Organiser's Full Name
*
First Name
Last Name
Organiser's Contact Number
*
eg. Email, Phone Number, etc
Speaker's Name
*
First Name
Last Name
Speaker's Organisation
*
Title of Talk
*
Subject Matter
*
Has the speaker spoken at a university event before?
*
Yes
No
Has the speaker been refused to speak publicly or at any other educational establishment before?
*
Yes
No
Is the content or subject of this person's speech likely to incite racial hatred or constitute extremist views that risk drawing people into terrorism or are shared by terrorist groups?
*
Yes
No
Is the content or subject of this person's speech likely to incite racial hatred or constitute extremist views that risk drawing people into terrorism or are shared by terrorist groups?
*
Yes
No
Do you have any concerns that the speaker will not abide by the Universities Dignity and Respect Procedure?
*
Yes
No
Are there any other details about the event that should be noted, i.e. if the event is approved, is there a likelihood of media interest? Does the event have any controversial subjects? If so please provide details:
As the member of Newcastle University Students' Union Club/Society Committee who is arranging a room for this external speaker you are responsible for answering the above questions as accurately as possible. I confirm these details are correct and consent to being contacted with relevant information. Read the NUSU Privacy Policy at www.nusu.co.uk/privacy
*
Yes
Please verify that you are human
*
Submit
Should be Empty: