Forms: Dean Participation Request

Requestor's Name: *

Phone Number: *      Email Address: *

Contact's Name: *

Phone Number: *      Email Address: *

Name of Function: *

Date of Function: *

Function Start Time: *

Function End Time: *

Type of Function: * ------ Reception Breakfast Luncheon Dinner Meeting Other

Type of Function (if other):

For breakfast, luncheon, or dinner requests, please list names of the people who will be seated at the Dean’s table:

Location *
(if off-campus, give exact address, telephone number of site, and parking information):

Purpose/Background of Event: *

What time does the Dean need to be at this function? *

How many people will be in attendance? *

Who is the audience? *

Are you requesting the Dean to speak at this function? *

• No, The Dean Will Be Attending As A Guest Only
• Yes, We Would Like To Request The Dean Speak At The Function

If yes, type of speech (please select one): ------ Welcome Introduction Opening Remarks Closing Remarks Award Presentation Speech Other

If "Other", please specify:

If "Introduction", please provide a bio of the person being introduced:

If the Dean is unavailable to attend, would you like the Vice Dean or another representative to take his place? (Please specify an alternative who may best meet your needs.) *

Additional Requests or Comments: