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DEAN’S PARTICIPATION REQUEST FORM *Please Return Completed forms to Kate Sheridan in the Dean’s Office (MRH 205)* Requestor's Name: Phone Number: Name of Function: Date of Function:
Time of Function:
Type of Function (Please check one) Reception Other
Breakfast
Luncheon
Dinner
Meeting
(Please Specify)
Location (If off campus, give exact address and telephone number of function site) What time does the Dean need to be at this function? Who will be our contact person for this function? Name: Phone Number: How many people will be in attendance? If this request is for a breakfast, luncheon or dinner, please list the names of the people who will be seated at the Dean’s table:
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 to speak at the function. Please select one. Closing Remarks
Introduction
Other
(Please Specify) **For introductions, please provide bio of person being introduced.**
School of Leadership and Education Sciences Dean’s Participation Request Form
Speech
Opening Remarks
Welcome
Revised 7/31/08
Award Presentation
What time will the Dean be speaking? How long do you want the Dean to speak? What would you like the Dean to talk about? Please give specific subjects.
Who is the audience? **What is the desired outcome of this event/function that the Dean can assist in accomplishing by speaking?
Will there be other speakers? No Yes—Please List: Additional Requests or Comments:
School of Leadership and Education Sciences Dean’s Participation Request Form
Revised 7/31/08