McGee Speaking Engagement Information Form

Thank you for inviting Dr. Jerrihlyn McGee to take part in your event. To ensure that her participation proceeds smoothly, we request that you provide the following information. For questions you are currently unable to answer, please indicate when you expect to be able to provide the information.

Event name*

Event Organizer (This person should be able to assist with any last-minute issues.)*

First NameLast Name

Event Organizer's email*

example@example.com

Event Organizer's Phone Number*

Area CodePhone Number

Event Start Date and Time*

DateHourMinutesAM/PM Option

Event End Date and Time*

DateHourMinutesAM/PM Option

Date and Time Details. Please specify when Dr. McGee is expected to participate and when she is expected to arrive at or join the event. *

The event will be*

in-personvirtual

Event Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

URL of link Dr. McGee should use to join the event*

Is Dr. McGee expected to deliver any formal remarks?*

yesno

How long is she expected to speak? Please indicate the requested start and end time of her remarks.*

Is Dr. McGee expected to deliver any informal remarks?*

yesno

How long is she expected to speak? Please indicate the requested start and end time of her remarks.*

Will Dr. McGee be participating in a conversation, fireside chat, panel discussion or Q&A with the audience?*

Please list special guest(s) who will be present.*

Please provide a list of questions, topics or resources that Dr. McGee can use to prepare for her participation.*

Please describe the anticipated audience for this event.*

Is the event open to the public?*

yesno

Will the event be recorded, and will photos be taken?*

yesno

Does an honorarium accompany this request?*

yesno

Please share any other information that might be necessary for preparing for this event.*