Request a speaker Speaker request form Heading link Copy link Class instructor's name * Required First Last Email * Required SPH division or program * RequiredCHSDrPHEOHSEpi/BioHPAUndergradOther program at UICCourse title * Required What students are in this course? * RequiredCheck all that apply. Undergraduate MPH Doctoral Medical students Other How will the speaker attend?In-personVirtualHybridTo be determinedHow long will the speaker join your course? * RequiredThis helps determine compensation.60 minutes or less60-90 minutes90+ minutesTo be determinedWhat class date(s) and time(s) would you prefer the speaker to join? * Required Speaking topic * RequiredPlease share some information on the class session topic and the topic(s) you would like the speaker to address. Anything else you would like us to note?