Host Site Application Form

North American Speaker Series, 1998-1999

Please complete this form and return to Lisa Murphy, Australian Studies Officer, prior to 10 July 1998.

You may send electronically by using the form below

(it will go by email if your browser is properly configured)

Or, you may print out the form and post to Lisa at

Or, you may print out the form and fax to Lisa at

(202) 332-8304

Name of the Australian Speaker you would like to host:

Dates you would like to host the visitor:

Contact information for the individual(s) who will be responsible for the speaker's visit and who will work with Lisa Murphy to organize the visit. Please list their name, title, phone, fax, email, and address:

If not, where?

What is the anticipated audience (students, faculty,the community):

What is their knowledge of Australia and the topic:

Will the speech be part of a conference, university lecture series, a special event or seminar:

How do you plan to advertise the event:

How did you hear about the Speaker Series:

Does the institution agree to pay for the speaker's local, on-ground expenses: ... yes ... no

Do you, the primary host, agree to provide Lisa Murphy with a detailed itinerary of the speaker's visit prior to the visit: ... yes ... no

Additional comments:

Please note, you will not see any message confirming that your form has been sent. But you will see a notice if it was NOT sent! There's a lot of trust involved here. It is always a good idea to follow-up with an email message to Lisa.

Thank you for your interest in the North American Speaker Series.

Lisa Murphy will notify you via letter regarding your request to host a speaker.

If you have any questions regarding the Series, please contact Lisa Murphy, Australian Studies Officer, Australian Education Office, phone (202) 332-8285, fax (202) 332-8304, email: [email protected].