Name:
Street Address / PO Box:
City, State, Zip:
Home Phone:
Work Phone:
Email:

1. Describe the humanities presentation you are proposing for Utah’s Public Square:

2. What personal experience and/or academic humanities background has encouraged
your interest in this topic?

3. If you plan to use another catalyst for discussion besides a talk, please describe it
(film clip, writing, etc.)

4. Explain why you think this topic would be of interest to Utahns.

5. Please suggest three or four questions you propose to stimulate audience discussion.

6. Describe your past experience as a speaker and discussion leader of humanities-related topics.
If you have had experience as a teacher or professor, please identify the course(s) and age
group of your classes.