Office of the President Event Request Form
Please fill out the form below, providing as much detail about the event as possible. Materials, such as invitations or draft agendas,
should be submitted with the completed form to Chintan Desai and Deb Zielinski. If you have any questions about this form, please
call 401-825-2188, or 401-825-2022.
Contact Information
Primary Contact Day-of Contact/Venue Contact
Department: Day-of Contact Person:
Name: Email:
Title: Phone:
Email: Venue contact person:
Office phone: E-mail:
Mobile phone: Phone:
Event Information
Event title:
Primary event host:
Other event sponsors:
Description/purpose of the event:
Day/Date of event:
Time of event:
Dress Code: Has the President attended this event before?
Location
Location/Venue:
Address:
Location notes:
Audience
Number of attendees:
Others invited to attend (officials, community leaders, award recipients, etc.)
1.
6.
2.
7.
3.
8.
4.
9.
5.
10.
If the President is unable to attend, would you like a representative to attend the event?
Requested designee (please provide name):
to
Office of the President Event Request Form
President’s Role
Requested arrival time:
Requested length of stay:
Will there be a speaking program? Time of speaking program:
Would you like the President to speak?
If yes, please fill out the remarks section of the form.
Other event speakers (if applicable):
Please submit a draft agenda for the speaking program and/or the event run-of-show.
President’s Remarks
Type of remarks requested: Time of remarks:
Length of remarks:
Note any specific topics/programs that you would like the President to address, include to whom (specify individuals and their role)
she should provide thanks and why. Please also provide any relevant data upon which she may focus and build remarks.
Speaking Points: People to thank:
Additional Information
After completing the form, please save the documents to your computer and email the PDF to Deb Zielinski, dmzielinski@ccri.edu
and Chintan Desai, cddesai@ccri.edu.
Choose one
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