UNIVERSITY GUEST PRESENTER AGREEMENT EXHIBIT
Last Revision: 01/02/2024

UNIVERSITY GUEST PRESENTER AGREEMENT EXHIBIT

Form Instructions

  1. Select the date the form is actually being completed from the drop-down calendar.
  2. Enter the name of a University contact person
  3. Enter the name of the University area sponsoring the guest presenter, lecturer, and/or speaker.
  4. Enter the name of the guest presenter, lecturer, and/or speaker.
  5. Enter the date, time, and location of the engagement.
  6. Enter any special notes or details regarding the engagement. If there are no special notes or details please indicate none or non-applicable (N/A) in the space provided.
  7. Enter the fee to be paid by University to guest presenter, lecturer, and/or speaker.
  8. Enter any additional costs and expenses (if any) to be reimbursed by University. Provide a description and/or explanation of the additional costs. If no additional expenses are anticipated, please indicate none or non-applicable (N/A) in the space provided.
  9. Enter the name of the Guest as it is to appear on the check for payment.
  10. Enter the SIMBA Supplier # of the Guest
  11. Check the appropriate authorization box. Options include:
    • I DO authorize University to conduct any form of photographing, recording, and/or broadcasting of my engagement
    • I DO NOT authorize University to conduct any form of photographing, recording, and/or broadcasting of my engagement.
  12. If Guest is being paid directly, then residency status must be declared by Guest by checking the appropriate box for tax purposes. Select one of three options as to the Guest status:
    1. Guest is a United States Citizen
    2. Guest is a Permanent Resident. A Non-Employee Information Form and W9 form must be completed and included with the submission of this form.
    3. Guest is neither a United States Citizen nor a Permanent Resident. A Non-Employee Information form, as well as all required documentation to authorize payment. The completed Non-Employee Information form and required documentation must be included with submission of this form.
  13. Enter the name of the guest
  14. Enter the complete mailing address of the guest
  15. Enter the name of the University Official authorized to sign this form
  16. Enter the title of the University Official
  17. The guest must provide either a hand-written signature or provide their digital ID
  18. If the guest provided a hand-written signature, enter the date the form was signed. If a digital ID provided, skip this field
  19. The University Official must provide either a hand-written signature or provide their digital ID
  20. If the University Official provided a hand-written signature, enter the date the form was signed. If a digital ID provided, skip this field

The appropriate University Official signs and dates the form after the guest has signed. The University Official printed name and title fields may be left blank if the guest signature has already been applied. The original is to be held by the Unit and a photocopy to be given to the Presenter. The original is uploaded as supporting documentation to Non-PO Invoice.

Image of University Guest Presenter Agreement Form