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Requests for Scholarship and/or
Creative Titles for Presentation

Faculty/Staff Research & Creativity Fall Forum
October 25, 2007

In order to avoid a delay in processing your application, please be sure to completely fill out the entire form. For questions contact Gina at gameg@rf.buffalostate.edu.

Step 1

Individual Presenter

Multiple Presenters (If multiple presenters, please be sure to fill out the information below.)

Step 2

Name:

Email:

Department:

Extension:

Faculty (list title):

Staff (list title):

Graduate Student (major):

Undergraduate (major):

Title of Presentation:

Step 3

Description for program booklet (individual presenters, 150-word limit; groups, 400-word limit):

Step 4

Special Requests:

Tables (how many?)

Chairs (how many?)

Easels (how many?)

Access to electrical outlet?

Presenters will be responsible for all other equipment. We will make every effort to accommodate your request, but due to the volume of presenters and limited space, this may not be possible.

Step 5

This step is ONLY for Multiple Presenters to fill out.
Individual Presenters are done - please click submit at the bottom of the page.

Contact Person:

Email: Extension:

Presenter #1

Name:

Email:

Department: Extension:

Faculty (list title):

Staff (list title):

Graduate Student (major):

Undergraduate (major):

Presenter #2

Name:

Email:

Department: Extension:

Faculty (list title):

Staff (list title):

Graduate Student (major):

Undergraduate (major):

Presenter #3

Name:

Email:

Department: Extension:

Faculty (list title):

Staff (list title):

Graduate Student (major):

Undergraduate (major):