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President's Attendance Request Form

President's Attendance Request Form

To request President Keshen's attendance at your event, please complete the form below.

Title of Event * Event Date * Contact Name * Contact Email * Contact Phone Number (work) Contact Phone Number (cell) Location and Room Number * Address Parking Availability * Description (topic, audience, other speakers, etc.) * Anticipated Number of Guests * Anticipated Dignitaries/Special Guests; Pronunciations and Formal Titles (if appl) * Role Requested (general welcome, opening remarks, keynote address, etc.) *

If the President is unavailable, are you seeking a designate? * Yes No

Length of remarks * Please provide 3-5 points/themes that would be of interest to your audience (as detailed as possible) *