Speaking Engagement Form

Speaking Engagement Formmichend2021-10-13T14:47:52-05:00

Dr. Elizabeth Kennedy – President
Missouri Western State University
(816) 271-4237 | president@missouriwestern.edu

Please complete this form with the most currently available information.

Contact Name*
Date request made*
MM slash DD slash YYYY
Contact Phone*
Contact Email*
Name of group or event*
Date of Event*
MM slash DD slash YYYY
Time of Event*

: Hours

Minutes

AM/PM
Location of Event*
On-site contact name*
On-sight contact phone*
Type of speech*
Please note the length of time to speak*
Where should Dr. Kennedy park, if necessary?
Where should Dr. Kennedy enter the building?*
Where should Dr. Kennedy enter the room?*
Will media be present?*
Will the event be recorded or livestreamed?*
Expected number of attendees*
Attendees are (select all that apply)*
- Public
- Students
- Administrators
- Faculty
- Other
Other attendees*
Additional details regarding audience or the event
Requested length of remarks*
Will there be a podium for use?*
Is there a question/answer period?*
Will there be a microphone for use?*
Is a PowerPoint presentation necessary?*
If yes, is a clicker provided?*
Will there be other speakers?*
If known, please provide names
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