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Speakers Bureau - Change Request Form

This form is for Fitchburg State College faculty for the purpose of maintaining the Speakers Bureau online listings. Be sure to check off the option indicating whether this is an addition, modification or deletion. If this is a modification request enter ALL information (including old subject matter you would like to keep listed). You will receive an email confirmation once your request has been completed.

Type of Change: Addition   Modification    Deletion*

*If you would like to delete your information from the Speakers Bureau listing just complete the First Name, Last Name & Email fields.
First Name
Last Name:
Department:
Topics:
Please hit <enter> or <return> between each topic.
Email:

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