SJSU President’s Office — Event/Speech Request

SJSU Office of the President — Event/Speech Request Form
Section 1: Requestor Information
Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Title / Department / Organization*

TitleDepartment/ Organization
Section 2: Event Details
Event / Meeting Title*
Date*

MonthDayYear
Date
Start Time/ End Time*

Hour Minutes

AM/PM Option

Until
until
Hour Minutes

AM/PM Option
Location / Address*
Event Type:*

On-CampusCommunity eventMeetingConferenceOther
Section 3: President’s Role
Requested Role:*

Welcome (1–3min)Short Remarks (4–9min)Full Speech (10+min)PanelAttendance OnlyOther
Proposed Topic / Focus:*
Is a PowerPoint or visual presentation needed?*

YesNoOther
Please provide brief talking points that the president will use for her remarks *
Focus on what’s important for the President to say to this audience.
Section 4: Audience
Approximate Attendance:*
Key Individuals to Acknowledge or Meet:*
Please Provide Name, title, organization, and reason for recognition.
Demographics / Focus of Audience:*
(e.g., high school students, local leaders, tech professionals):
Section 5: Logistics
Event Contact / Onsite Lead:*
Contact Cell (day of event):*
Event Setup (check all that apply):*

PodiumStageMicSeatingScreensLivestreamOther
Attire*

BusinessBusiness CasualFormalAcademic Regalia
Media Expected*
If Media is Expected Please Describe:
e.g., TV, print, university photographer
Additional Comments:
Should be Empty:

SJSU Office of the President — Event/Speech Request Form