- American Association of Colleges for Teacher Education

Online Speaking Engagement Request Form

Full Name(Required)

Title

Institution / Organization(Required)

Website

Email Address(Required)

Phone(Required)

Event Name/Theme(Required)

Event Location(Required)

The location should include Venue, City, and State

Event Date(Required)

Event Start Time

Event End Time

Start Time

NOTE: The times requested for the President's participation should be as exact as possible, as we may schedule multiple events the same day.

End Time

NOTE: The times requested for the President's participation should be as exact as possible, as we may schedule multiple events the same day.

Attire(Required)

Business Professional

Business Casual

Casual

Type of Event(Required)

Please describe(Required)

Is the President being requested to speak?(Required)

Yes

Please indicate what level of participation the President would have in your event:

What is the group's objective in having the President speak or attend?

Does the group have any special interests, topics or concerns that should be addressed?

Anticipated number of attendees?(Required)

Should the remarks be formal or conversational?

Formal

Conversational

Please describe the audience:(Required)

Is there anything else that you would like for us to know about your event?

What are the guidelines for travel budget and arrangements?

Will you handle arrangements?(Required)

Yes

Onsite event contact name and cell phone number

Other notes