Osher Institute Proposal Form

Thank you for your interest in speaking at the Osher Lifelong Learning Institute. Please complete this form and submit it for review. This form cannot be partially completed or saved to finish later. Information with an *asterisk is required. After submitting, please remain on the webpage for a moment so the form can process. You will receive an email confirmation once the submission is complete.

Deadlines For Proposals: Fall semester – February 1; Spring semester – August 1

Required fields are indicated.

TODAY'S DATE:(Required)

YYYY

Contact Information

NAME:(Required)

Prefix First Last

Please provide a phonetic pronunciation of your first and last name.

MAILING ADDRESS:(Required)

Street Address City State / Province / Region ZIP / Postal Code

BUSINESS EMAIL ADDRESS:(Required)

PERSONAL EMAIL ADDRESS:(Required)

BEST PHONE NUMBER:(Required)

EMERGENCY CONTACT NAME:(Required)

First Last

EMERGENCY CONTACT PHONE NUMBER:(Required)

If you have been or are employed at Boise State University, please provide your employee ID number. (If not a Boise State employee, reply "N/A.")(Required)

For HR purposes, please provide your Boise State University employee ID number again. (If not a Boise State employee, reply "N/A.")(Required)

Program Proposal Information

Proposal Title (70 characters or less):(Required)

Proposal Description (150 words maximum:)(Required)

This may be edited for the Osher Institute catalog or other promotional materials.

Presentation Delivery – PLEASE NOTE: Once a delivery method is assigned, this cannot be changed. (Check one):(Required)

Lecture (One, two-hour presentation. Allows for a 10-minute break and approx. 10-15 minutes for questions. Total time: 90-100 minutes.)

Short Presentation (Same as Lecture, but meets for two or three sessions on the same day of the week and same time of day.)

Workshop (Intended for smaller audiences, discussion, and/or hands-on activities.) Minimum capacity is 40; maximum capacity is 65.

Special Event: Tour of a facility or exhibit. Minimum of one hour to a maximum of two hours. No honorarium is available for these events, but a complimentary Osher membership is provided.

Special Event: Special Speaker opportunity, Meet the Author, or musical or theatrical performance. May include lecture/talk with the audience. One to two hours.

If you are suggesting a SHORT PRESENTATION, please indicate the number of sessions:

If you are suggesting a WORKSHOP, please indicate the number of sessions:

If you are suggesting a SPECIAL EVENT, please indicate the number of hours:

Presentation Delivery – Other Option (Please describe your event and outline the amount of time proposed.)

Scheduling Preferences

Preferred semester (NOTE: No programs are held in mid-March during Boise State University's Spring Break week.)(Required)

Preferred day/time (check all for which you are available):(Required)

Monday, 1:30-3:30 p.m. MT

Tuesday, 10:00 a.m.-12:00 p.m. MT

Tuesday, 1:30-3:30 p.m. MT

Wednesday, 10:00 a.m.-12:00 p.m. MT

Wednesday, 1:30-3:30 p.m. MT

Thursday, 10:00 a.m.-12:00 p.m. MT

Thursday, 1:30-3:30 p.m. MT

Friday, 10:00 a.m.-12:00 p.m. MT

Saturday, 10:00 a.m.-12:00 p.m. MT

Please note any days of the week when you are NOT available (or N/A):(Required)

Brief Biography and Photo

Please email your current headshot to osher@boisestate.edu. Provide your brief bio (up to 500 characters) If your proposal is selected, we will use this to introduce you.(Required)

Please select one of the following:(Required)

Please confirm the following:(Required)

I understand that if my proposal is selected, I must participate in a brief orientation session to ensure a seamless presentation. Osher staff will schedule a convenient time prior to the date of the presentation.

Speaker Status

Osher may provide a modest speaker honorarium when funds are available. Please indicate a preference by selecting ONE option.(Required)

Waive any honorarium. (Thank you! The funds will remain in the Osher Institute self-supporting operating budget to support year-long programming.)

Waive any honorarium, but I’d like to receive a complimentary, one-year membership to Osher that includes annual parking at Yanke Family Research Park. (Value of $200.)

I am NOT an employee of Boise State University and may be considered an Independent Contractor. If an honorarium is offered, I understand that I must comply with requirements of Boise State’s payment system, Payment Works, as the sole payment option. I understand I am solely responsible for submitting accurate information, including my current address, business and financial institution information. Should I fail to meet deadlines or provide necessary information, I understand that the honorarium will be waived and instead, a one-year membership to the Osher Institute will be provided.

I am currently a full-time, benefits-eligible faculty member or employee of Boise State University and understand that any honorarium will be payable via University payroll, and that the total reflects and includes a partial contribution to the speaker’s fringe benefits. (Example: $100 honorarium = $78 speaker fee plus $22 for the mandatory 22% contribution.)

I am currently a full-time, benefits-eligible faculty member or employee of Boise State University. I prefer to have any honorarium transferred to my Boise State department. I understand that my department’s local budget account strand must be sent to osher@boisestate.edu. by the deadline, and that failure to meet the deadline will result in a declined honorarium and instead, I will be provided a one-year membership in the Osher Institute.

I am currently a part-time, non-benefits-eligible adjunct faculty member or employee of Boise State University. Any honorarium will be paid via University Letter of Appointment, and the total reflects and includes a partial contribution to the speaker’s fringe benefits. (Example: $100 honorarium = $91 speaker fee plus $9 for the mandatory 9% contribution.)

I am not a U.S. citizen and understand that the Osher Institute is unable to provide an honorarium. I may receive a one-year membership to the Osher Institute.

Referred to the Osher Institute by (or N/A):(Required)

Thank you for taking the time to complete this proposal form. We look forward to reviewing it.

When you submit this form, an email will be sent to you as a record of the information you provided.

You will be notified of your proposal acceptance in the months following the August 1 and February 1 deadlines. We ask for your patience as we work through the process of proposal selection; please wait to hear from us about our Osher programming decisions.

** PLEASE NOTE: After clicking “Submit,” DO NOT close the browser window until you receive a confirmation message that your proposal was received, as it sometimes takes a few seconds to process. If you have submitted the form correctly, you will receive a confirmation email with a copy of the information you provided.