North Atlantic Regional Director Appearance/Engagement Request Form

North Atlantic Regional Director Appearance/Engagement Request Form
Greetings,

Please complete the below form if your chapter or organization is requesting the presence, or written journal greetings of Elicia Pegues Spearman, Alpha Kappa Alpha Sorority, Incorporated®, North Atlantic Regional Director.

This form should be submitted at least six (6) weeks prior to the date of your event, but we welcome you to complete for event dates that you are aware of as far out as twelve (12) months.
YesNo
- Chapter Name*
- Basileus Name*
- Chapter Mailing Address *
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Cluster ICluster IICluster IIICluster IVCluster V
- GraduateUndergraduate
- College/University*
- Chapter Instagram Handle*
- Primary Contact Name*
  
  First NameLast Name
- Title*
- Email*
  example@example.com
- Phone*
  Format: (000) 000-0000.
- Secondary Contact Name
  
  First NameLast Name
- Title
- Email
  example@example.com
- Phone
  Format: (000) 000-0000.
- YesNo
- Day of Event Escort Name:*
  
  First NameLast Name
- Escort Title*
- Escort Email*
  example@example.com
- Escort Phone Number*
  Please enter a valid phone number.Format: (000) 000-0000.
- What amenities are you providing to Madam Regional Director as an invited guest? (e.g. hotel, travel, ticket to event, etc.)*
- Organization Name*
- President Name*
- City*
- State*
- Primary Contact Name*
  
  First NameLast Name
- Title*
- Phone Number*
  Please enter a valid phone number.Format: (000) 000-0000.
- Organization Instagram Handle*
- Primary Contact Name
  
  First NameLast Name
- Title
- Email
  example@example.com
- Phone Number
  Please enter a valid phone number.Format: (000) 000-0000.
- Be a guest speakerBring greetings/remarksServe as keynote speakerGive presentationSend written greetings (i.e. souvenir journal ads)Send video greetings
- Subject/Topic:*
- What length of time is requested for MRD to present?*
- Deadline for receipt of written or video greeting. (Must be no less than six [6] weeks prior to publication deadline.)
  
  MonthDayYear
  Date
- YesNo
- Event Title*
- Event Occasion *
- Event Theme*
- Event Date *
  
  MonthDayYear
  Date
- Event Start Time*
  
  Hour Minutes
  
  AM/PM Option
- Event End Time*
  
  Hour Minutes
  
  AM/PM Option
- VirtualIn-Person
- PublicPrivate
- Event Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- CasualBusinessBusiness CasualSemi-FormalFormal
- YesNo
- Color scheme*
- Estimated number of attendees*
- YesNo
- Participating Directorate Members - Please indicate if she will provide greetings or remarks.
- YesNo
- YesNo
- Name of International President's designee*
  
  First NameLast Name
- Title*
- YesNoPossibly
- Name
  
  First NameLast Name
- Title
- Name
  
  First NameLast Name
- Title
- Name
  
  First NameLast Name
- Title
- Please share a copy of the flyer and any other external facing documents. If the file is too large, please email these documents to the following: narfirstcos@gmail.com, narfirstcommsreq@gmail.com, narfirstprotocol@gmail.com and narfirstphilacters@gmail.com.
  
  Cancelof
- The agenda and run of show must be submitted two weeks prior to event. If it is not available at time of submission, please email these documents narfirstcos@gmail.com, narfirstcommsreq@gmail.com, narfirstprotocol@gmail.com and narfirstphilacters@gmail.com.
  
  Cancelof
- Specific items, awards and recognitions to be noted:
- Speaker request details (name of the person introducing the North Atlantic Regional Director or any other pertinent information needed).
- Will there be other dignitaries from other organizations participating/attending? If so, please provide names and organizations.
- Event summary (limit to 200 words or less)
- Zoom/WebExGo To Meetings/ Go To WebinarOther
- When will the link be provided?*
  
  MonthDayYear
  Date
- Who will provide the link?*
- YesNo
- What time should North Atlantic Regional Director sign-on/join?
  
  Hour Minutes
  
  AM/PM Option
- Should be Empty: