Fillable SCHEDULING REQUEST FORM: CHANCELLOR HAROLD L. MARTIN, SR. (North Carolina A&T State University)

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SCHEDULING REQUEST FORM: CHANCELLOR HAROLD L. MARTIN, SR. (North Carolina A&T State University)

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SCHEDULING REQUEST FORM: CHANCELLOR HAROLD L. MARTIN, SR.
INSTRUCTIONS
PLEASE ALLOW THREE WEEKS FOR THE CONSIDERATION OF YOUR REQUEST.
Requests will not be confirmed more than six weeks in advance of the event.
Complete this form in its entirety (three pages). An incomplete form will not be considered a formal request and the provided
information will not be considered for scheduling.
Press releases, advertisements, invitations, programs, photographs and other materials that use the chancellor’s name/likeness
or indicate his attendance at an event must be reviewed and approved by the Office of the Chancellor before being distributed.
Attach to/with this form a copy of any available brochure, flyer, agenda or additional information related to the event and the
chancellor’s role.
The chancellor’s schedule is subject to change at any time due to university business and other responsibilities.
_______________________________________________________________________________________________________
GENERAL CONTACT INFORMATION
Date of request
Na
me of requestor Email address
Day phone Cell phone
Name of person responsible
for event Email address
Day phone Cell phone
_______________________________________________________________________________________________________
EVENT INFORMATION
Day (of the week) and date of event
Name of event
Br
ief description of event
Lo
cation
Lo
cation phone
Rai
n site (if outdoor event)
Rai
n site phone
- mor
e -
SCHED
ULING REQUEST FORM: CHANCELLOR MARTIN
Page 2 of 3
_______________________________________________________________________________________________________
EVENT INFORMATION, cont.
Start time
End time
T
ime by which chancellor must arrive
Leng
th of time required of chancellor
(attach agenda)
Would
it be beneficial for chancellor to remain
throughout event? If yes, why?
Will dignitaries attend or participate?
If yes, attach list with role at event.
Audience (in
clude all possibilities)
_______________________________________________________________________________________________________
THE CHANCELLOR’S ROLE
Please check all that apply:
Preside over occasion
Bring greetings
Pro
vide opening remarks
Deliver the occasion
I
ntroduce speaker/participant
I
ntroduce keynote speaker
Serve
as moderator
Part
icipate in a panel discussion
Pre
sent award(s)/honor(s)
Ackno
wledgements
Part
icipate in a ceremony (attach details)
Provide
closing remarks
Ot
her (specify)
- mor
e -
SCHEDULING REQUEST FORM: CHANCELLOR MARTIN
Page 3 of 3
_______________________________________________________________________________________________________
THE CHANCELLOR’S ROLE, cont.
If speech is required, what is desired length?
Topic of speech
Ta
lking points to address (attach)
Will the
re be other speakers? Describe.
_______________________________________________________________________________________________________
OTHER DETAILS
Who will greet the chancellor upon his arrival?
Name
Title
Day
phone and cell phone
Designated or general parking?
Attach directions to parking area.
Will a meal be provided?
Indicate whether before, during or after program.
Where will the chancellor be seated?
Indicate table, dais (platform), etc.
If at a table, who will be seated with the chancellor?
Attach list if necessary.
From where will the chancellor speak?
Indicate lectern, table, out in the open, etc.
Indica
te if the following will be available:
Microphone
(indicate type)
Equipment for PowerPoint presentation
Return the completed form and attachments to Paige Clark at mpclark@ncat.edu.
UR 0813
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SCHEDULING REQUEST FORM: CHANCELLOR HAROLD L. MARTIN, SR. (North Carolina A&T State University)

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Completed 24 August 2020

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