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Plan to Assign Form

Planning to have a group of students visit the Speech Center as part of your course? Fill out the form below so we can prepare to meet your needs. Please email Jeanne Hollister with a copy of the syllabus and particularly assignments related to speaking or formal discussion in class to accompany your form.

Referring Professor:
Course name and number:
Expected number of students
to visit the Speech Center:
Individually: In groups of:
Number of visits per student/group:
Approximate dates of visits:
Special instructions or criteria attached:

After submitting this form, please email your assignment guidelines to

Once this completed form, accompanied by assignment guidelines, has been received by the Speech Center, it is added to the “Faculty Assignments on File” folder. The student speech consultants will refer to this in order to provide your students with the best possible assistance.