Central Regional Director Engagement Request Form
Please submit requests a minimum of three months in advance. However, if the invitation is for a keynote, please submit six months in advance per Alpha Kappa Alpha protocol guidelines.
Email
*
example@example.com
Type of Request
*
Please Select
Keynote Speaker
Attendee Only
In-Person Greeting (Welcome)
In-Person Greeting (Closing Remarks)
Workshop Presenter
Written Greetings
Video Greetings
Other (If you select other, please provide details)
Type of Request (select all that apply)
*
Description of "Other"
Name of Requester
*
Chapter or Organization
*
Region (if applicable)
*
Phone Number
*
Please enter a valid phone number.
Event Name
*
Event Theme
Audience Type
Please Select
Alpha Kappa Alpha Members Only
Public (Non-Members may attend)
Attire for the Event
*
Event Location (name of venue and complete address)
*
Date of the Event
*
-
Month
-
Day
Year
Date
Event Start Time
*
Hour Minutes
AM
PM
AM/PM Option
Event End Time
Hour Minutes
AM
PM
AM/PM Option
Timezone of the Event
*
Additional Details
*
Please Upload the Event Flyer or Invitation
*
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