VPSL Speaking Request

Event

Name of Event(Required)

Event Type(Required)

In Person
Virtual

Location(Required)

Platform for Virtual Meeting(Required)

(Zoom, Teams, etc.)

Date of Event(Required)

Start Time(Required)

:

End Time(Required)

:

Preferred VPSL Arrival Time(Required)

:

Dress for Event(Required)

Does the event involve a meal?(Required)

(Such as a luncheon or dinner.)

Yes
No

Type of Service(Required)

Sit down
Buffet

Brief Description of Event(Required)

Sponsoring Organization(Required)

Speaker will be introduced by

Name(Required)

First Last

Title(Required)

VPSL Considerations

Requested Participation of VPSL(Required)

Welcoming remarks (3-5 minutes)
Short remarks (5-10 minutes)
Speech (15-20 minutes)
Additional time for Q&A
Other

Other – Describe in Detail(Required)

On-Site Point of Contact

Name(Required)

First Last

Title(Required)

Email(Required)

Cell Phone(Required)

Form Completed By

Name(Required)

First Last

Title(Required)

Email(Required)

Cell Phone(Required)

Submit Request

CAPTCHA

Event

Speaker will be introduced by

VPSL Considerations

On-Site Point of Contact

Form Completed By

Submit Request

Giving

911 Guide

Contact Student Life