Professor for a Day

UA Swoosh

Professor for a Day Participation Form

Fields that are required are identified with a *

Faculty/Class Information
Faculty Name:	*
Department Name:	*
Faculty Email:	*
Class Name:	*
Class Number:	*
Lecture Topic:	*
Date of Lecture:	*
Time of Lecture:	*
Location of Lecture:	*

Speaker Information
Name:	*
Company Name:	*
Title:	*
Speaker Email:	*
Phone:	*
Address:	*
City:	*
State:	*
Zipcode:	*
CBA Alumni:	Yes No *
College Affiliation
Please attach your resume, if available:
Additional Information:


Optional
Can we add your information to the CBA speaker database? If so, what are your specialties?