John Stein Speaking Request Form

Event Information

Event Name

Event Date and Time

Location

Invited Guests and/or Groups

ex. students, faculty, staff, alumni

Size and Composition of Audience

Length of Remarks

A/V Equipment Required for Presentation

Projector, screen, laptop

Talking Points for Remarks

Are there specific points you would like the speaker to cover? Enter them on new lines.

Objective and Brief Background of Event

Event Timeline

in Agenda/Program format

Additional Information

Your information

Submitted by

Phone

STUDENT LIFE