Speaking Engagement Request

Name of Event/Meeting

Purpose of Event/Meeting

College President's Role

(If the College President cannot attend, would you like him to designate someone else?)

Date/Time

Type of Event/Meeting

Event/Meeting Location

City/State

Sponsoring Department

What other community leaders will attend?

Approximate number of attendees

Where will the College President park?

Are you requesting the College President speak?

Approximate time during the event/meeting the College President would speak

Topics you would like the College President to address in his remarks

Recommended acknowledgements of community leaders to include in the College President's remarks

Contact Name

Contact Phone Number

Contact Email Address

I AM...