Classroom Guest Speaker CONTRACT Request Form

Ac Affairs - Classroom Guest Speaker CONTRACT Request Form

Please read before completing this form:
** Prior to submitting this form, you should submit a Classroom Guest Speaker REQUEST Form, which will be reviewed and approved by our Dean of Academic Affairs. You should only complete this Classroom Guest Speaker CONTRACT Request Form after obtaining approval from the Dean of Academic Affairs.

** Please allow at least 14 days before your speaker’s visit for the contract to be completed (e.g., if your guest speaker’s visit is on January 15, you should submit the Classroom Guest Speaker REQUEST Form no later than end-of-day January 1).

** It is recommended that you type your responses in a Word or Google Doc and then paste them into this form (and remember to save the document in case you need it later as a reference).

** This form is the Classroom Guest Speaker CONTRACT Request Form, and it is used to gather the information the Academy needs to create a contract for your classroom guest speaker’s visit. You should not fill out this Classroom Guest Speaker CONTRACT Request Form until your information is final.

** At any point, you may click the “save & continue” button to save your progress and return to this form later (for up to 30 days). Please note that the “save & continue” button is NOT the submit button. You will still need to click the “submit” button when your form is complete in order to submit your request.

** If your classroom guest speaker is visiting virtually (not coming on-campus, in-person), this form will be shorter. If your guest speaker IS coming on-campus, in-person, you will be asked to provide more details regarding housing, meals, scheduling, etc.

** PLEASE DO NOT FILL OUT THIS FORM UNTIL ALL OF YOUR DETAILS ARE FINAL. Out of respect to our colleagues in the Finance Office, you may not add/subtract extra events or activities to/from the guest speaker’s itinerary at the last minute (unless there is an extraordinary circumstance like a snow storm, illness, etc.), since doing so means we must void the original contract and create a new one. Please plan ahead, make a schedule/itinerary, and adhere to it. Fill out this form only after your guest speaker’s schedule/itinerary is finalized. Nothing on this form should be tentative.

** Please note that this form is only for guest speakers visiting classes (not for speakers exclusively for clubs or student activities, etc.) **

"*" indicates required fields

Section 1: Guest Speaker Information

Guest Speaker Name*

First Last

Guest Speaker Email*

Guest Speaker Cell Phone*

Guest Speaker Mailing Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

If the guest speaker has additional contacts, please list them here:

(Additional contacts may include an assistant or agent that will be arranging the speaker’s visit on their behalf.)

Will the guest speaker be providing the Academy with a contract?*

YES, I will upload it now.

NO, I need a contract drawn up.

Guest Speaker Contract*

Upload the Guest Speaker's contract here.

Max. file size: 39 MB.

Section 2: Requesting Faculty Member Information

Faculty Name*

First Last

Faculty Email*

Faculty Cell Phone*

Your department (select all that apply to this visit)*

E.g., If your guest is visiting American Studies, you should select English and History & Social Science. The dept. chair will receive a copy of your request.

English

History & Social Science

Language

Math

Philosophy & Religion

Science & Computer Science

Visual & Performing Arts

Are you the guest speaker’s on-campus contact?*

The on-campus contact is the individual who the speaker should contact with questions about the event, and who Finance should contact if they have questions about the visit.

Yes

Section 2.5: Contact On Campus Information

On-campus contact name*

First Last

On-campus contact email*

On-campus contact cell phone*

Section 3: Event Information

Brief Description of Guest Speaker and their Engagement*

Please write a sentence or two that summarizes the speaker’s visit. This should be short; you will provide more details later on in this form.

Select one:*

The speaker's visit starts & ends on the same day

The speaker's visit spans over one or more days

Visit Date*

Please check the Academy Calendar (on the Bulletin) to ensure you are not conflicting with another major event or a required student meeting/activity.

Visit START Date*

Please check the Academy Calendar (on the Bulletin) to ensure you are not conflicting with another major event or a required student meeting/activity.

Visit START Time*

Visit END Date*

Visit END Time*

Will this visit be VIRTUAL or ON-CAMPUS?*

Virtual: Speaker is visiting class virtually (via Zoom our other video conferencing method)

On-campus: Speaker is visiting class on-campus, in-person (additional questions required in Section 3.5)

Location of visit (if virtual, please include video conferencing method and the room on-campus that students will be in)*

Please note that if the event is not happening in your classroom during your class time, you are responsible for reserving an appropriate room through Time & Space.

You will now need to provide us with a DETAILED schedule/itinerary, with a brief description of each event.

** This schedule will be more substantial if the speaker is coming to campus and/or participating in several activities, but it can be quite short if the speaker is visiting virtually (e.g., a virtual visit description may just be: “Dr. Doe is Zooming into Period 3 U.S. History for 30 minutes to discuss her recent research on the American Civil War.”).

** General guidelines: Include the topic the speaker will be speaking about, times, locations, and participants for all activities. If your guest speaker is visiting your class, meeting with department members, attending lunch, or participating in any other activity during their visit, make sure you include all of those details. This schedule should be FINAL and should NOT be changed after submission of this form unless there is an extraordinary circumstance.

** You may also upload a PDF or Word Document that has the schedule, if that is easier for you.

Choose an option for providing us with your guest's DETAILED schedule/itinerary*

I would like to type or paste text in this form

I would like to upload a PDF or Word Document that has the schedule/itinerary

DETAILED schedule/itinerary, with brief description of each event.*

Upload your guest's DETAILED schedule/itinerary, with brief description of each event.*

Max. file size: 39 MB.

Will the event/guest be recorded (video or audio)?*

You should select “yes” if faculty/staff, students, and/or Communications will be recording any formal or candid videos or audio.

Yes

Will the event/guest be photographed?*

You should select “yes” if faculty/staff, students, and/or Communications will be taking any formal or candid photographs.

Yes

Will the event/guest be livestreamed?*

You should select “yes” if the event will livestreamed in any way.

Yes

Section 3.5: Accommodations Information

This section must be completed if the guest speaker is visiting a class on-campus, in-person. Virtual visits do not require this information.

Will the speaker require housing?*

Yes

Will the speaker arrange their own housing, or will it be arranged by the Academy?*

Speaker is arranging their own housing

Housing arranged by the Academy

Will Deerfield be reimbursing the speaker for housing, or is this included in the honorarium?*

Reimbursed by the Academy

Included in the honorarium/not reimbursing

Where is the speaker staying?*

Note that the requesting faculty member is responsible for arranging all housing and conveying detailed housing information to the guest speaker. You do not need to make a reservation prior to filling out this form, but you will need to once the contract is signed.

Housing payment*

The Academy is paying for housing directly (via DA credit card, etc.)

Faculty member is paying for housing and will need to be reimbursed by the Academy

Other

Will the speaker require meals?*

Yes

Meal details (select one)*

Speaker will eat meals on-campus in the Dining Hall

Speaker will eat in the Dining Hall and off-campus

Speaker will only have meals off-campus

Will Deerfield be reimbursing meal costs accrued off-campus or is this included in the honorarium?*

Reimbursed by the Academy

Included in the honorarium/not reimbursing

Will the speaker require transportation?*

Yes

Will the speaker provide their own transportation, or will it be provided by the Academy?*

Providing their own transportation

Transportation provided by the Academy

Will travel expenses be reimbursed or included in the honorarium?*

Reimbursed by the Academy

Included in the honorarium/not reimbursing

Please provide transportation details:*

Include expected transportation type and approximate pick up/drop off time & location. Note that the requesting faculty member is responsible for arranging all transportation and conveying exact details to the guest speaker. You do not need to book travel accommodations prior to filling out this form, but you will need to once the contract is signed.

Section 4: Honorarium Information

Will the speaker receive an honorarium?*

Yes

Honorarium Amount*

Note that the budget holder must have approved your use of funds.

The honorarium should be charged to account #*

If you do not know the account number, please contact your Dept. Chair to obtain it prior to filling out this form.

Section 5: Additional Information

We ask that you allow at least 14 days before your speaker’s visit for the contract to be completed (e.g., if your guest speaker’s visit is on January 15, you should submit the Classroom Guest Speaker REQUEST Form no later than end-of-day January 1). If you are not meeting this deadline, and the speaker is visiting in 7 days or less, please let us know:

The guest speaker is visiting in 7 days or less

The guest speaker is visiting in 5 days or less

If you have any special requirements for this visit/event, please provide details:

Please note that you are responsible for contacting the appropriate office on campus (e.g., Physical Plant, Communications, ITS, Dining) if you require any of their resources/services.

I understand that all information on this form should be finalized information. I understand that I can’t add/subtract extra events or activities to/from the guest speaker’s itinerary at the last minute (unless there is an extraordinary circumstance like a snowstorm, illness, etc.). I have planned ahead, made a schedule/itinerary, and I will adhere to it.*

Yes, I understand and I have.

What happens next?

** Once submitted, this form will be sent to our Finance Office, who will review it and create a contract for the guest speaker in DocuSign.

** The Finance Office MAY reach out to you if they have any questions.

** You will be notified when the DocuSign process is complete and the guest speaker has signed the contract.

** Remember to click the “submit” button to submit your request, and please don’t close this window until you receive an on-screen confirmation message!

** A copy of the form will be sent to you via email (if you do not receive the email, please contact academics@deerfield.edu, as it’s possible you did not hit the submit button and we did not receive your form).

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Classroom Guest Speaker CONTRACT Request Form

Ac Affairs - Classroom Guest Speaker CONTRACT Request Form

Section 1: Guest Speaker Information

Section 2: Requesting Faculty Member Information

Section 2.5: Contact On Campus Information

Section 3: Event Information

Section 3.5: Accommodations Information

Section 4: Honorarium Information

Section 5: Additional Information

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