Dean Speaking Engagement Request Form

Please submit this form at least three weeks in advance of the event in question.

Dean Speaking Engagement Request Form Heading link

Contact name: * Required
First Last
Contact phone: * Required
Contact email: * Required
Event host/sponsor (e.g., department, campus, committee): * Required
Event name: * Required
Event date: * Required
MM slash DD slash YYYY
Event start time: * Required

: Hours

Minutes

AM/PM AM/PM
Speaking program start time: * Required

: Hours

Minutes

AM/PM AM/PM
Location: * Required
Please describe the event's purpose and focus: * Required
Who is the audience, and how many people are expected to attend? * Required
Upload draft of event program, if available. If unavailable, see box below
Max. file size: 15 MB.
Program: Please list additional speakers and anticipated elements of the event. * Required
Who will introduce the dean? * Required
Will the dean introduce another speaker? * Required
- Yes
- No
Please enter the name, title and institution of the speaker being introduce. * Required
What time is the dean expected to begin speaking? * Required

: Hours

Minutes

AM/PM AM/PM
For how many minutes is the dean expected to speak?
Please enter a number from 0 to 60.
Goal of the dean's appearance? * Required
Specific points you would like the dean to address: * Required
Will the dean answer questions from the audience or other program participants? * Required
- Yes
- No
Is the dean expected to attend the entire program/post-event reception? * Required
- Yes
- No
Event history
If this is a recurring event, when and why was it established? How often is it held? Does it have any traditions? Include any notable details.
List all other VIPs expected to be in attendance: * Required
Include leaders of other organizations. Indicate "none" if that is the case.
List any internal or external issues the dean should be aware of:

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College of Nursing

Dean Speaking Engagement Request Form

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Dean Speaking Engagement Request Form

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Dean Speaking Engagement Request Form Heading link