Event Request Form - Office of the Chancellor

Thank you for your interest in having Chancellor Martin participate in your event.

For administrative purposes, please fill out this form to request appearances and remarks. All requests will be reviewed in a timely manner.

Event Request Form

Event Name *

Location *

Date *

Start/End Time *

Chancellor’s Arrival/Departure Time *

Event Host/Sponsor *

Role of the Chancellor * Role of the Chancellor

Special Instructions

Event Objective *

Number of Invitees *

Primary Constituent Group * Primary Constituent Group

Submitted By *

Name, Title & Office

Submitter Email *

Submitter Phone *