PRESIDENTIAL SPEAKER REQUEST FORM
Please return to president@ttuhsc.edu
To confirm the Presidents availability and participation, this request is due no later than 2 weeks prior to event.
EVENT DATE: START
TIME: END TIME:
EVENT NAME:
ORGANIZATION HOLDING EVENT:
HAS THE PRESIDENT ADDRESSED THIS GROUP OR ORGANIZATION IN THE PAST?
YES NO IF YES, WHEN? ___________
EVENT/ORGANIZATION WEBSITE:
EVENT BACKGROUND (ATTACH ADDITIONAL SHEETS IF NECESSARY):
ORGANIZATION BACKGROUND (ATTACH ADDITIONAL SHEETS IF NECESSARY):
EVENT LOCATION: ___
ROOM: _______________________
ADDRESS: ____
LOCATION TELEPHONE: _____ _______________
WHO WILL GREET THE PRESIDENT: MOBILE #: _____
PARKING: _______________________________________________________________________
SEATING: _______________________________________________________________________
PRIMARY CONTACT(S)
NAME:
TITLE:
ASSISTANTS:
OFFICE TELEPHONE: ______________________________________________________
MOBILE #: _______________________________________________________________
ATTIRE
CASUAL
BUSINESS
COCKTAIL
BLACK TIE
AUDIENCE
EXPECTED NUMBER IN ATTENDANCE: (RSVP LIST DUE 2 DAYS PRIOR TO EVENT)
PLEASE LIST ELECTED OFFICIALS/VIPs:
REMARKS (REQUESTED TOPIC OF PRESIDENT’S REMARKS):
SUGGESTED LENGTH OF REMARKS:
BRIEF
5 MIN 10 20 MIN OTHER ___________
INTRODUCED BY (PLEASE PROVIDE BIO):
TITLE:
PLEASE ATTACH AGENDA
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