Speakers Bureau Application Name* First Last Institution*Department*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code CountryAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email* Asian Studies Program DescriptionGrant HistorySpeaker Preference and RationalePlease list requested speakers in order of preference and provide a rational for each. Discuss the specific benefits of hosting the requested speaker at your institution inclusive of expected campus events, lectures, classroom visits, public presentations, or other activities planned for the speaker during the visit. Requested Speaker (first choice)*Rationale for first choiceRequested Speaker (second choice)Rationale for second choiceRequested Speaker (third choice)Rationale for third choiceInstitutional Letter of SupportInclude a letter of institutional support for the grant signed by an academic dean that explicitly states: Grant money will be administered by the institution without administrative fee. Grant money will be used by the institution to provide for the speaker's expenses, including as needed: (1) transportation (airfare, car rental, or mileage), (2) ground transportation and airport parking, (3) lodging, (4) all meals, and (5) a minimum $500 honorarium. That the institution will provide a (minimum) $500 honorarium to the speaker. That any expenses incurred, but not covered by the $1,500 grant award, will be borne by the host institution and not the guest speaker or ASIANetwork. That the host institution will initiate the planning and scheduling of travel and visit arrangements, and communicate and coordinate with the guest speaker as needed. That the host institution will submit a brief written report to ASIANetwork within one month of the speaker's visit. That the institution assumes full responsibility for bringing the guest speaker to its campus and releases ASIANetwork of any liability arising from activities undertaken in connection with the grant. That the institution will return any unspent grant funds to ASIANetwork at the conclusion of the grant activities. Upload Dean's Institutional Letter of Support*Sample Letter of Support Addressed to ASIANetwork Executive Director [Name of Institution] agrees to administer the ASIANetwork Speakers Bureau grant, without an administrative fee, in support of the speaker's transportation, lodging, meals, and a minimum honorarium of $500. Any expenses not covered by the $1,500 grant award will be borne by [Name of Institution], not the guest speaker or ASIANetwork. [Name of Institution] will bear responsibility for planning, travel and lodging arrangements, and communication and coordination with the guest speaker. [Name of Institution] assumes full responsibility for bringing the guest speaker to its campus and releases ASIANetwork of any liability arising from activities undertaken in connection with the grant. [Name of faculty member] will provide a report on the speaker's visit to campus within one month.