Distinguished Lecturer Form

The Chapter Technology Transfer Regional Vice-Chair for your Region must approve the information submitted on the form before it is forwarded to ASHRAE headquarters. You will receive a confirmation e-mail, media kit, program information, and Event Summary Critique Form within three days of receipt of the Distinguished Lecturer Participation Form.

Fields marked (optional) may be left blank — everything else is required.

1 Visit Details

Allocated Visit Unallocated Visit

Has the CTTC Regional Vice Chair been notified of this visit?

Region:

CTTC Regional Vice Chair:

Host/Organizing Chapter:

Lecture Date* *Must be between July 1 and June 30 of current society year.* *Form must be submitted at least 15 days prior to the visit date.*

2 Multi-Chapter Visit

Is this a multi-chapter visit?

Yes No

If no, please explain: (optional)

Additional Participating Chapter 1

Name:

Date:

Additional Participating Chapter 2

Name:

Date:

Additional Participating Chapter 3

Name:

Date:

3 Co-Sponsorship

Is this a joint meeting with another industry organization? (AIA, USSGBCI, etc.):

Yes No

If yes, who? (optional)

4 Lecturer & Presentation

Name of Lecturer:

Presentation Title(s):

2. (optional)

3. (optional)

Date(s) of visit:

Visit Start Date:

Visit End Date:

5 Meeting Logistics

Has each of the Host Chapters discussed arrangements for local transportation, hotel, meals, miscellaneous expenses, and honorarium, with the DL?

a. What meeting type is this?

In-Person Virtual Both In-Person and Virtual

b. Will the Chapter pay for the DL's transportation (i.e., flight or drive) to the meeting?

Yes No

6 Host Chapter(s)/Section(s) Technology Transfer Chair(s)

Chapter

Name

Chapter

Name

Chapter

Name

7 Review & Submit

The Chapter Technology Transfer Regional Vice-Chair for your Region must approve and sign this form before it is forwarded to ASHRAE headquarters. You will receive a confirmation e-mail, media kit, program information, and Event Summary Critique Form within three days of receipt of the Distinguished Lecturer Participation Form. ASHRAE Headquarters will begin confirming visits on July 1.

Applicant Email *Note that all form fields are REQUIRED for submission.*

ASHRAE DISTINGUISHED LECTURERS PROGRAM PARTICIPATION FORM

Regional Vice Chair, CTTC Response

ASHRAE Staff Response