Contact Phone Numbers*

Please provide office and cell for day-of event needs.

Event Location*

Complete address including room number

Function Atmosphere (and attire)

Business

Casual

Formal (Black Tie)

Other

Nature of Audience

Students

Faculty

Staff

Alumni

Community

Check all that apply

Role President is to Play

Attendance Only

Participation

If you checked "Participation," describe the nature of the role

Welcome Remarks

Panelist

Master of Ceremonies

Introduction

Informal Discussion

Keynote Address/Presentation

Interview or Q&A

Award Presentation

Other

Choose all that apply

Will the following items be available?

Podium

Presentation Screen

Computer

Microphone

Should they plan to stay for the entire event, if possible?

Yes

No

Please email any additional background material (program agenda, confirmed guest list, table/eating arrangments, guest names of others at the table, bios, speaker's notes, description of your organization, etc.) to larnett@memphis.edu.

Text Messages (Optional)

I agree to receive text message communications from the University of Memphis