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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)

Contact Information

NAME:(Required)
MAILING ADDRESS:(Required)
EMERGENCY CONTACT NAME:(Required)

Program Proposal Information

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)

Scheduling Preferences

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

Brief Biography and Photo

Please confirm the following:(Required)

Speaker Status

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

** 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.