Sponsoring Organization

Theme of Conference or Campus Event (if applicable)

Address

City, State, Zip

Country

Contact Person(s)

Contact Email

Contact Phone

Date of Speaking Engagement

Duties (Please describe what you might want Cherrie Moraga to do during her engagement stay (e.g. public lecture or reading, classroom visits, meeting with students, groups, workshops, etc.)

Budgeted Honorarium

Any other comments