Dr. Audrey Butler Event Appearance Request

Thank you for your interest in having Embry-Riddle First Lady, Dr. Audrey Butler, participate at your event. To help us streamline the process, please initiate the request for an event appearance or speaking engagement by submitting the form below.

Requests should be made well in advance of your event to ensure the best chance of securing a date on Dr. Audrey Butler’s calendar. While some details may not be initially available, it is recommended that you submit the form with sufficient information related to the event and about your organization.

Publications using Dr. Audrey Butler’s name, photo, or bio must be approved prior to printing or distributing - not excluding listing her name as a confirmed guest on invitations or programs. If you need Dr. Audrey Butler’s photo or bio for the event, please make a written request to the Office of the President. All requests from media must be coordinated through the University Communications Team, and any direct calls are forwarded accordingly.

If you have any questions, please contact Ceely Ann Lonergan in the Office of the President at (386) 226-6200 or via email at lonergac@erau.edu.

* All fields are required. Some parts within the form allow you to upload materials.

Event Title:*

Date:*

Event Start Time:*

Event End Time*

Required Arrival Time:*

Purpose of the event?*

Provide a brief summary of the event, include its history and its purpose (i.e. annual ceremony, monthly meeting, all-day conference; will there be other speakers, award presentations, etc.).

Event Location (venue, address – include campus, building, floor or room number, parking details):*

Provide directions to the event from Embry-Riddle, Daytona Campus, or from Henderson Welcome Center if the event is on campus, and preferably with a map illustrating directions.

Upload a Map (optional):

Upload a File

Is this a virtual event?*

YESNO

If this is a virtual event, please provide instructions for connecting.*

Who is greeting Dr. Audrey Butler upon arrival and where will they meet?*

Upload Event Agenda or Program:*

Upload a File

What is Dr. Audrey Butler's role during the event?*

Guest / Attendance OnlyJudge / PanelistSpeaker / InterviewPresenter / Awards

If remarks are requested, what type?

Welcoming Remarks (2-3 min)Brief Remarks (3-5 min)Speech (10-15 min)

On what topic?*

Include 4 – 6 key points to emphasize during the speech (i.e. interests/concerns to address and acknowledgments of audience members; such as sponsors, dignitaries or officials, and etc.).

Who will introduce her? Will she introduce someone following her?*

What is the number of attendees?*

Who is the audience? Who will be your VIPs?*

What is the recommended attire?*

What are the seating arrangements?*

Describe if Dr. Audrey Butler is part of a stage party, any special seating, head table, ticketing information, registration requirements, etc.

Will there be a photographer at the event?*

YESNO

Who will distribute the photos after the event?*

Will the event be recorded or broadcasted?*

YESNO

Is the media invited?*

YESNO

Requested by (Name, Title):*

Department/Organization:*

Phone Number:*

Email Address:*

Mailing Address:*

City:*

State / Province:*

Postal / Zip Code:*

Dr. Audrey Butler Event Appearance Request

EVENT INFORMATION

CONTACT INFORMATION