Event Participation Form

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President Thames is looking forward to speaking at your upcoming event! To assist in the planning process, please complete the following form, providing as much detail as possible. Thank you!

Requests must be submitted four weeks in advance to the President's Office.

EVENT PARTICIPATION FORM

Contact Information

Name*

First Name

Last Name

Department

Phone Number

E-Mail address*

Event Information

Full Official Name of Event

Date/Time (start) of Event

Date/Time (end) of Event

Location/Zoom Link

Contact Person at the Event

Phone

E-mail

Focus/Theme/Purpose of Event*

Expected Audience Size*

Audience will include (Check all that apply)

Students Faculty Staff Alumni Community Elected Officials Select Group Members

Speech Details

Type of Remarks Requested

Welcoming Remarks Keynote Address Additional Time for Q&A

Other:

Additional Information for Speech/Remarks*

Please share some highlights or stats from the year to feature in the speech/remarks (i.e. “Serving 750 students this spring,” “largest graduating class,” “record number of students enrolled in program,” etc.)

Name of Event Organizers(s)

Please list the name(s) of the office/department/committee coordinating the event.

Contact Information

Event Information

Request Information

Speech Details