Idaho Humanities Council: Apply Online for an IHC Speaker

Apply Online for an IHC Speaker

Required fields are in bold.	Please submit your application at least 6 weeks before program date.
Today's date	2010-09-06
SPONSORING ORGANIZATION:
Name:
Address:
City:	State: Zip:
Phone:
Website	http://
Email:
CONTACT PERSON: (Supply address, phone, etc. ONLY if different from above.)
Name:
Address:
City:	State: Zip:
Phone:
Email:
Cell Phone:
SPEAKER:
Speaker:
Title of Talk:	Choose a speaker first, from above
Program Date:	Time:
Estimated Audience
Location Address:
Building/Room Name/Number:
City:	State: County:
Program Format (dinner, business meeting, social, etc.):
I have confirmed the date and equipment needs with the speaker: (please initial)
I would like to receive a flier to help promote this event.	Yes.
Brief description of the event for our online calendar. (This may be edited and will appear pending approval.)
$50 per presentation fee: Paying by: Credit card (link will be provided after this form) Check payable to Idaho Humanities Council in mail