Regional Activity Request Form

Regional Activity Request Form

Submission of Form does not guarantee approval of the activity and/or date.
Hosting Committee Name*
Select all committee's whose help would make the event a success.
Event Contact*

First NameLast Name
Contact's Email*
example@example.com
Who is the Secretarial Liaison for your committee?*
Has the Secretarial Liaison been informed about this activity?*

YesNo
Activity Details
Type of Event*

In Person OnlyVirtual OnlyHybrid
Expected Location
1st Choice Proposed Date*

MonthDayYear
Date
Hour MinutesAM/PM Option
2nd Choice Proposed Date

MonthDayYear
Date
Hour MinutesAM/PM Option
3rd Choice Proposed Date

MonthDayYear
Date
Hour MinutesAM/PM Option
Description of the Activity*
How will the activity be promoted?*

Social MediaEmail BlastOther
Necessary Support Committees

Advisors TaskforceArts and Letters CommitteeChaplain's CouncilCollegiate Connection CommitteeConflict Resolution CommitteeDID CoordinatorEmergency Response TeamGrow with Google CoordinatorHeritage and Archives CommitteeInformation and Communications CommitteeInternational and Small Chapter Support CommitteeInvestigations CommitteeJournalist CommitteeLEADLeadership Development CommitteeMembership - DearsMembership - HostessMembership IntakeMembership Services CommitteeParliamentarianPearl Program CommitteePress Forward Towards your Purpose CommitteeProgram Planning and Development CommitteeProtocol and Traditions CommitteeReactivation TaskforceRegional Membership Intake CoordinatorRehabilitation CommitteeRisk Management CommitteeRitual and Ceremonies CommitteeSocial Action CommitteeSpecial Events & Projects CommitteeState/Country FacilitatorState/Country/Continent CoordinatorTechnology CommitteeUndergraduate and University Affairs Committee
Should be Empty: