Speaker Request Form - Office of the President

Please complete this form with as much information as early as possible and submit no later than six (6) weeks prior to the event. Speaker requests are not considered final until the requestor completes the following form and the President's Office approves.

Note: If out-of-town or overnight travel is required, contact Kathryn Mason in the President's Office at ext. 4521 to submit additional required information.

Contact/Requestor:

Phone Number

Email

Department/Office

Event Title

Who's Hosting

Date of Event

Start Time

End Time

Location/Address

Event Description (200 words)

Provide 4-6 key bullet points for President's remarks.
These points will form the basis of his remarks. Please balance brevity with thoroughness:

Targeted Audience
(indicate all that apply)

Alumni

Board of Trustees

Faculty

General Public

Legislators/Community Leaders

Other

Parents

Staff

Students

Size of Audience

1-20 21-50 51-100 100-200 Above 200

Type of Presentation

Major Address (20+ minutes)

No Remarks Necessary

Panel Discussion

PowerPoint Presentation Required

Short Remarks (5-10 minutes)

Speech (15-20 minutes)

Time Duration:

Welcoming Remarks (3-5 minutes)

When will the President be called to speak?

Who will introduce the President?

Title

Brief Bio

Will the President be requested to introduce other speakers?

YES NO

Is the President's bio required?

YES NO

Is a photo required?

YES NO

If applicable, insert electronic event invitation and/or agenda link here.

Will there be other speakers?

YES NO

Will there be dignitaries in the audience?

YES NO

Are you planning on having students in the audience of the event?
(If yes, you are expected to secure student attendance)

YES NO

Are the press/media expected to attend?

YES NO

Are there notable Stockton alumni in the audience?

YES NO