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Special Event Attendance/Speaker Request Form

Special Event Attendance and Speaker Requests for Kent State University President or Provost

Requests must be submitted a minimum of six weeks in advance. Requests are granted for only the president or the provost to speak at an event, not both.

Contact Information    *Indicates Required Fields

Sponsoring Unit or Organization*:  

Event Contact*  

Contact Phone*:  

Contact E-Mail*:  

Contact Mailing Address:  

Contact Fax:

Event Information

Name of Event*:  

Event Date*:  

Event Time
Start Time*   End Time*:  

Program Start Time*:  

Event Size* (approximate number of attendees):  

Event Location*:  

Event Dress/Attire*:



  Formal/Black Tie    

Attendee/Speaker Information

Requested Attendee*



Will Requested Attendee Be Speaking?* 



Note: If you are requesting the attendance of both the President and the Provost, you must fill out a form for each. You may request for both to attend, but only one to speak.

Type of Remarks Requested*:

  Welcome (3-5 min)    

  Short Remarks (5-7 min)    

  Speech (10-15 min)    

  Keynote Address (20-25 min)    


Topics to be Addressed* (if not applicable, put NA):

Key Talking Points* (if not applicable, put NA):

Other Event Speakers:

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