Guest Speaker Funding Request Form

Guest Speaker Funding Request Form - Spring 2026
The Medical Humanities (MDHM) Program supports guest speakers for classes that count toward the MDHM minor. Funding amounts depend on course classification:
- Courses offered exclusively as MDHM (as well as MDHM/ENGL 272) are eligible for up to $250 in honorarium support, plus a parking pass.
- Courses that count as electives for the MDHM minor (including those cross-listed and not cross-listed with MDHM) are eligible for up to $125 from MDHM, with the expectation of additional departmental funding. MDHM will also cover a parking pass.
- Virtual visits are eligible for up to $125 for both MDHM and non-MDHM courses that count as electives.
*Please note that these funds are meant to support local speakers, and no additional travel funds are available.

Deadline: Friday, December 05, 2025

Notifications will be sent by: Friday, December 12, 2025
Faculty Information
Name

First NameLast Name
Email
example@example.com
Department
Course Number
Course Title
Guest Speaker Details
Speaker Name
Affiliation and Title
Proposed Date of Visit
Talk Title or Topic
Brief explanation of how this speaker supports course content
Funding Request
Amount requested from Medical Humanities
Have you requested funding from another source?

Yes, and it has been approvedYes, but it is still pending responseNo, but I plan to request funding from other sourcesNo, I do not plan to request funding elsewhere
If you selected any of the first three options, please provide the following details
Source of funding
Amount requested
Amount approved (if applicable)
Status or additional comments
Should be Empty:

Guest Speaker Funding Request Form - Spring 2026

Faculty Information

Guest Speaker Details

Funding Request