UPAF Performer Speaker Request
Company Name
*
Campaign Coordinator
Gretchen Titus
Gunna Middleton
Event Title
Event Date
*
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Month
-
Day
Year
Date
Event Start Time (We will share arrival time based on performer/speaker set-up needs)
*
Hour Minutes
AM
PM
AM/PM Option
Event End Time
*
Hour Minutes
AM
PM
AM/PM Option
Anticipated Attendance Number
*
Day-of Contact Name (must be onsite)
*
First Name
Last Name
Day-of Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address(es) for Performer/Speaker Confirmation (Planning Committee & Onsite Contact)
*
Request Type
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Speaker Only (10-15min)(UPAF Staff Member or Member Group Representative)
Performer With Testimonial (15-30min) (Singer, Actor, Dancer)
Activity or Workshop (15min-1hr) (Dance, Stretching, Theatre)
Mini-Concert *Prior Approval Required
Performer for Donor Experiences Events
Please provide any additional details for your event and desired speaker or performer. (Ex. We would like to highlight Arts Education.. Preference for interactive workshop...Performance will welcome employees in to work.)
*
Event Room Type (Ex. Cafeteria, Conference Room, or Room Dimensions)
Venue Can Provide (Please Select all that apply)
Microphone
Power Access
Wood Floors
Piano
Armless Chairs
Sound System (for accompaniment)
Load In/Out (Certain dance groups will need to bring in their own flooring)
Event Address/Location
*
Detailed Arrival Instructions, Including Security Needs & Parking Details (validation appreciated)
*
Additional Instructions
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