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Event Information

Event Name:*

Event Date:*

Is the date flexible? *

Event start time:* : AM PM

Event end time:* : AM PM

Timeframe/duration of the President's attendance:*

Is this time flexible?

Yes No

Locations:*

Purpose of event:*

How would the President's attendance contribute to the success of your event?*

President's role:

Guest Speaker

Audience Information

Main message you want the audience to take away:*

Specific type of audience: *

  Trustees
  Regents
  Benefactors
  Faculty/Staff
  Current Students
  Prospective Students
  Alumni
  Community
  Parents
  Other:

Please state what other audience:  

Number of guests expected:*

Brief description of the audience:*

Will there be food?

Yes No

History of event:*

Additional Information/Comments:

Contact Information

Request made by:*

Email:*

Department/Organization:*

Phone Number:*

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