Mr. Ms. Mrs.
Presenter Name:
First Name Middle Initial Last Name
Address City State Zip Work Phone Home Phone Cell Phone Email
Please complete the appropriate section below.
Student
School Major or Discipline Expected Graduation Date Degree
School Department Specialization
Employer Job Title
Community Affiliations: Please list any relevant memberships or volunteer associations
Country of Origin Language(s) spoken
Arts Crafts Culture Current Events Development Foreign Policy Geography Health History Holidays Language Lifestyle Music Politics Religion Traditions
Type of Presentation(s):
oral presentation demonstration cultural performance
Have you worked with the K-12 Outreach Program in the past?
Yes No
How did you first learn of the K-12 Outreach Program?
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