Propose a 5CLIR Project or Event

Instructions

The starred items are required for initial consideration by the Special Projects and Events Committee, but please fill out as much as possible. Rough estimates of costs, potential speakers, and suggestions for locations and dates are all helpful; please indicate whether these are currently only estimates or ideas.

Submission Date (today's date) *

Month Day Year

Title of the project or event: *

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Primary Contact person: *

First Name Last Name

Email address: *

Phone Number *

Area Code Phone Number

Additional Contact person:

First Name Last Name

Email address:

Phone Number

Area Code Phone Number

Description of the project (maximum of 250 words): *

0/250

Who is the intended audience? *

0/50

Location(s) where the event will be held:

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Will you partner with another institution? If so, describe the nature of the partnership:

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Participants: Speakers, Presenters:

0/50

Amount of financial Support Requested from 5CLIR:

Granting agencies to which you are applying for support:

0/50

Will the event be free, or will there be admission charged? If so, how much?

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Proposed date(s) for the event (note that dates must be coordinated with the 5CLIR calendar):

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Project budget estimate : (enter details below)

Fees for speakers, honoraria, etc:

Space rental:

Overnight housing for speakers/ participants:

Food/ catering:

Advertising & printing:

List any relevant experience you have had in planning this type of event:

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Please provide copies of all supporting documentation to the Special Project Committee.

When you click the submit button, your proposal will automatically be emailed to the Special Projects Committee, to the 5CLIR office, and to the e-mail address you supply below.

E-mail *