Part I: Media Release
Part II: Speaker Questionnaire
- Name (as it should appear in all publications):
- Title (as it should appear in all publications):
- Company Name (as it should appear in all publications):
- Mailing Address:
- E-Mail Address:
- Speaker’s Assistant’s name:
- Assistant’s E-Mail:
- Assistant’s Phone Number:
- Speaker’s on-campus contact:
- Title of the speech?
- Nature and content of speech:
- Preferred format of speech?
- Does the speaker want to mail any materials to be distributed during or after the speech? If yes, please describe:
- Does the speaker have a book or other prominent piece of press material that is important to them or that is relative to their speech at hand?___If so, would the speaker be willing to sign copies?____
- Please describe all audiovisual (AV) needs (microphone, PC, etc.):
- Are translation/ interpretation services needed?
- Does the speaker have any disability (e.g., in a wheelchair, etc.) of which we should be aware so that we can make appropriate arrangements?
- Does the speaker have any particular dietary requirements?
- Beverage preference during the event?
- Are there any other special needs, requirements or requests of which we should be aware in planning for the speaker?
- Does the speaker require any specific security arrangements?
- Will the speaker be travelling alone or will she/he be accompanied?
If the speaker will be accompanied, what are the names and titles of those people?
Do they have any special needs?
- Print photo
- Electronic photo (.jpg or .gif)
- Company website