Speaker Request Form
Thank you for your interest in having President Mary Schmidt Campbell attend your event. Please complete the form below with as much information about your request as possible.
Hosting Organization and Event Title *
Point of contact (please include name, email address and primary phone number) *
Date and time of event (please include start and end times, as well as the time zone) *
Objective and brief background of event *
Audience profile and key participants (please include size and demographics) *
Time frame/duration of the president's participation and responsibilities (please include pre-event meetings/calls, tech check, the event itself, Q&A, post-event activities, and amount of time for each) *
Describe the nature of the president's role *
If requesting substantive remarks, what topic(s) will be discussed? *
Names and titles of other speakers or panel participants *
Is the event open to the public or will access be limited? *
Is the event open to the media? *
Will the event be recorded/videotaped? *
If there are any promotional materials for the event, please indicate here. *
Please include amount of honorarium being offered, if any. *
Please provide any other pertinent information the president should have in reviewing your request. *
Please Note
In addition to the above information, the following should also be provided:

* If the president’s name/image/likeness is noted on invitation or material for an event, drafts must be submitted to the President’s Office for review and approval prior to printing.

* Order of program/run of show due three business days prior to event.
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