Osher Institute Proposal Form

TODAY'S DATE:

Name and Contact Information

NAME: *

Prefix First Last

Please provide a phonetic pronunciation of your name.

ADDRESS INFORMATION: *

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

EMAIL ADDRESS: *

PHONE NUMBER: *

CELL PHONE NUMBER:

EMERGENCY CONTACT NAME: *

First Last

CONTACT'S PHONE NUMBER: *

If you have you been, or are currently, employed at Boise State, please enter your employee ID number:

Proposal Information

Topic/Title: *

This is a proposal for a: *

Lecture (One-time, two-hour lecture presentation.)
Short Course (Two-hour, lecture-style presentations. Courses range from two to four weeks in duration and meet once a week.)
Seminar (Designed for smaller audiences with interactive discussion and hands-on activities. May meet for one, two, or three sessions.)
Workshop (Designed for smaller audiences, taking a deeper dive on a subject matter and with interactive discussion. May meet for one, two, or three sessions.)

Hours to present material

Please indicate the number of hours requested to present material in a two-hour session. Note that we limit short courses to a maximum of six hours.

Repeat Presentation *

I am willing to offer a repeat of my presentation, if requested.

Yes
No

Scheduling Preferences

Day of the week (select all that apply): *

Monday
Tuesday
Wednesday
Thursday
Friday

Time of day: *

Morning (10 a.m.-noon)
Afternoon (1:30-3:30 p.m.)
Either morning or afternoon
Other

Enter Other Time of Day

Semester to take place: *

Fall (August - December)
Spring (January - May)

Please note any dates you will be unavailable (blackout dates):

Please check one of the following: *

I plan on being in Boise to present in person from the Osher classroom.
I am not local and plan on presenting via livestream.

Proposal Description

Please provide a brief description of your program. *

This description will be reviewed and may be edited by staff for use in the Osher Institute catalog, both print and electronic. Presenters are provided a copy of any edited descriptions in advance. (Maximum 100 words.)

Biographical Information

Please provide your brief biography and a headshot.

Please email your headshot to osher@boisestate.edu. Both items may be used on the Presenter Biographies web page and in virtual webinar promotions. (Maximum 100 words.)

Equipment and Material Requirements

Please provide a list of anticipated special materials/equipment/audio-visual needs:

Our classrooms come equipped with a computer, projector, screen, lapel or headset microphone, and a slide clicker.

Speaker Status

Please select your preferred method of payment. *

We are pleased to offer a modest speaker honorarium to presenters at the Osher Lifelong Learning Institute. Note: You must be a U.S. citizen to receive an honorarium.

I am NOT a U.S. citizen and understand that I cannot receive a speaker's honorarium.
I would like to waive the honorarium (Thank you! Funds will remain in the Osher Institute operating budget to support year-long programming.)
I am NOT a current employee or faculty member of Boise State University. I will receive the honorarium via independent contract.
I am a current employee or staff member of Boise State University. I will receive the honorarium via Letter of Appointment through regular payroll.
I am a current faculty member of Boise State University. I would like the honorarium transferred to a Boise State department.

Consent *

By submitting this proposal, I understand that if selected, the presentation may be recorded for the viewing of Osher members unable to participate in the live event time.

I understand that selected proposals are added to Osher's archived programs list.

I understand that the Osher Institute prohibits any fundraising efforts or petitions to be promoted during a presentation.

I agree to the statements.

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 shortly after August 1 for Spring scheduling and February 1 for Fall scheduling.

** 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.