CSBR Speakers’ Bureau Request Form
The California Society for Biomedical Research (CSBR) arranges for physicians, veterinarians, laboratory staff, researchers, scientists, and others in the biomedical research field to speak to K-12 science and health classes and organizations throughout California and Nevada on topics ranging from the life sciences, careers in the field, the research process, animal care, and the importance of biomedical research. Speakers have expertise in such areas as gene therapy, cancer, Alzheimer’s disease, arthritis, alcohol and drug abuse, immunology, and HIV/AIDS.

Our speakers are pleased to share their work with teachers, students, and members of the general public free-of-charge.

Please complete and return this form to CSBR via fax or mail to arrange for a speaker.
Name:
School/Organization:
Mailing Address:
City:
State:
ZIP:
Email:
Phone:
Speaker for a:

Preferred Speaking Dates:
Preffered Speaking Times:
Age(s):
Grade(s)
Audience Size
Length of Presentation:
Please indicate which topics you would like the speaker to address:



Details:
Are there any pecial considerations the speaker should be aware of?
If yes, please explain:
Please indicate available equipment: