Propose a 5CLIR Special Program

Propose a 5CLIR Special Program
Submission Date (today's date) *

- Month - Day Year
Your name: *

First Name Last Name
Your email address: *
Your Phone Number *

- Area Code Phone Number
If the program will have a second organizer, enter their name :

First Name Last Name
2nd organizer's email address:
2nd organizer's Phone Number

- Area Code Phone Number
Program Title *
Program Subtitle (maximum of 15 words)

0/15
Proposed schedule (semester offered, proposed dates)

0/50
Proposed location(s)
Description of the program (maximum of 250 words):

0/250
Maximum number of participants :
Any other relevant information?
When you click the submit button, your proposal will automatically be emailed to the Special Programs Co-chairs, to the 5CLIR office, and to the e-mail address you supply below.
E-mail *
Should be Empty: