University Advancement

Requestor Information

Name*

First

Last

Email Address*

Phone*

Select One*

Have you reserved time on speaker's calendar for this meeting/event with Susan Geis?*

Date of Meeting/Event*

Time of Meeting/Event*

Meeting/Event Type:*

Name of Meeting/Event:*

Purpose of Meeting/Event:*

Office Hosting Meeting/Event:*

Approximate Meeting/Event size:*

Meeting/Event location (if known):

Purpose of Remarks*

How long will (insert name) need to speak? Enter time range:*

Is there a particular topic (insert name) should speak on based on the theme of your meeting/ event? Provide suggested talking points here:*

Who will be attending the meeting/event?:*

List "Others" here:*

Please provide any further information useful to this request: