Home / Chancellor’s Speaking Event Request FormChancellor’s Speaking Event Request Form Chancellor’s Bio Chancellor’s High Res Photo Formal Name of Event*Date of Event* MM slash DD slash YYYY Time of Event* : Hours Minutes AM PM AM/PM Organization Holding Event*Event/Organization Website Separate/Additional Event Sponsor(s)*Additional Documents*Please submit any invitations or documents with the Chancellor's name you intend to use for approval, prior to going to press or print. Drop files here or Select files Accepted file types: pdf, doc, docx, jpg, gif, png, Max. file size: 50 MB, Max. files: 5. LOGISTICSScheduling Contact from Organization (name, email, cell)*Primary Contact Name*The name of the primary contact for this event First Last Primary Contact (email)*The email of the primary contact for this event Enter Email Confirm Email Exact Location of Event (address, room etc.)*Please provide a map to the event locationAccepted file types: pdf, doc, docx, jpg, gif, png, Max. file size: 50 MB.ROOM SET-UPPlease provide a room set-up diagram Drop files here or Select files Accepted file types: pdf, doc, docx, jpg, gif, png, Max. file size: 50 MB, Max. files: 5. Will there be:* a stage? a podium? a sound system? None of the above. Who will greet and host the Chancellor?*Who will greet and host Mrs. Sharp?Attire* Casual Business Casual Business Cocktail Black Tie Line by Line Program of Event*AUDIENCEExpected Size of Audience*Audience Make Up*Notable Audience Members (elected officials, VIP’s)*PROGRAM/SPEECHName of Media Relations Contact from Organization* Email of Media Relations Contact from Organization* Press* Open Closed Who will introduce the Chancellor (please provide bio)?**NOTE: Short introductions are preferable Has the Chancellor spoken to this organization before?* Yes No If "Yes", when?Detailed Event Background (purpose of event)*What will the entire program cover? (line by line)*Please include recent achievements or milestones your organization has accomplished relevant to the event.*Suggested length of the Chancellor’s remarks?*What topics should the Chancellor’s remarks cover?*Are there Additional speakers?**Please list names and titles.Other dais/head table guests diagram.*please include diagram Drop files here or Select files Accepted file types: pdf, doc, docx, jpg, gif, png, Max. file size: 50 MB, Max. files: 5.
