Speech/event participation form
Event details
Event name:
Your answer
Location:
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Date:
MM
/
DD
/
YYYY
Start time:
Time
:
End time:
Time
:
Event type:
Event logistics
Please provide a brief agenda of the event (order of speakers and topics).
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What is the provost's role for this event?
Your answer
If speaking, what is the preferred length of comments?
Your answer
What is the presentation set up (podium, mic, etc.)?
Your answer
Who is the audience?
Your answer
Please describe any special concerns/issues/areas of interest that the group would like to hear addressed.
Your answer
Please list (if any) people in the audience who should be recognized (dignitaries from the group, politicians, donors etc.)
Your answer
Contact information
Contact person's name:
Your answer
Contact phone:
Your answer
Contact email:
Your answer
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