Speaking Request Form Do you want the President to speak at your event? Submit this form! Event InformationEvent Name/Title * RequiredDate of Event * Required Month Day Year Purpose of Event * RequiredStart Time of Event * Required : Hours Minutes AM/PM AM PM AM/PM End Time of Event * Required : Hours Minutes AM/PM AM PM AM/PM President's Arrival Time * Required : Hours Minutes AM/PM AM PM AM/PM Organization * RequiredPoint of Contact for Event * Required First Last Email * Required Enter Email Confirm Email Point of Contact's Phone # * RequiredAudience * Required Students Faculty Staff Alumni Elected Officials Your Group Only Venue InformationEvent Venue * RequiredThe name of the venue housing the event.Location Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code RoomLocation Phone #Expected Number of AttendeesRain LocationIf a rain location has been designated, please indicate it here.Open to Public? Yes No Do You Need a Photo or Bio? Photo Bio Media Expected? Yes No At the EventPresident's Role at Event * RequiredWelcome, keynote, etc. Issues for President to Address * RequiredPlease submit a short list of issues important to your organization for the President to addressEvent MC First Last Who Introduces the President? First Last Length of Time for President to Speak * RequiredWill There be a Podium? Yes No Is the President Expected to Introduce anyone? Yes No Whom Will the President Introduce? First Last Bio of Person President IntroducesAccepted file types: doc, docx, pdf, Max. file size: 50 MB.Will Awards be Presented? Yes No To Whom Will Awards be Presented? Who Will Present Awards?Order of Speakers Other Dignitaries Attending Event Function Attire * Required Business Casual Black Tie (Formal) Will Invitations be Sent From the President? Yes No Draft InvitationAccepted file types: doc, docx, pdf, , Max. file size: 50 MB.Please submit a draft invitation for approvalSpecial ArrangementsGuests at Head Table Head Table? Yes No Additional Special Arrangements?NameThis field is for validation purposes and should be left unchanged. Δ