OSD Prospective Guest Form

What is your name? *

First Name Last Name

What is your job title? *

What department/school are you contacting us from? *

E-mail *

example@example.com

Phone Number *

Area Code Phone Number

Is your speaker a representative of an organization other than Liberty University? *

Yes No

Are they speaking on behalf of the organization to promote opportunities for current Liberty students to participate in? *

Yes No

Name of Company or Organization? *

Main Website (Link) *

Does your organization have a formal relationship or affiliation through Liberty University? *

Yes No I don't know

Please share with us about any previous involvement or connection with Liberty University that your company or organization may have, including the names of any faculty or staff with whom you have developed a relationship. *

Please provide a brief history of your company or organization. *

Please outline your vision-statement for your company or organization. *

What countries do you have ongoing work in? (Please add all that apply to student opportunities) - Including US based opportunities. *

What types of service-engagement does your Organization offer? (Select all that Apply) *

What types of opportunities do you offer? (Select all that apply) *

In an effort to maintain safety and security for our students, our Risk Management department has provided ALL countries that we are unable to send students and promote travel opportunities. Per University policy, you are NOT allowed to recruit students to travel with you or promote any opportunities regardless of the nature to these countries. They currently are out of policy and pose a significant threat to their travel safety, educational outcomes and are prohibited by Liberty University. Due to the nature and seriousness of this policy, we ask that you present any questions to our office regarding specific locations within those various countries listed below. Please reach out to us and we will guide you in what is permissible. We want to serve you through this policy. We cannot thank you enough for both blessing our students while also ensuring the safety of the students’ future engagements.

No Travel Permitted or Promoted:

Iran
North Korea
Democratic Republic of Congo
Balkans
Belarus
Ivory Coast
Cuba
Iraq
Liberia
Sudan
Syria
Zimbabwe
Afghanistan
Libya
Somalia
Yemen
Ukraine
Burundi
Haiti
Madagascar
Tunisia
Central African Republic
Chad
Egypt
India (Jammu and Kashmir Provinces)
Israel (Gaza and West Bank Areas)
Lebanon
Mali
Nigeria
Pakistan
Russia (North Caucasus)
Thailand (Pattani, Yala, Sonkhala, Narathiwat Provinces)
Venezuela

Permission must be granted to promote any potential travel location(s) within each of these listed countries:

Algeria
Bahrain
Bangladesh
Bosnia & Herzegovina
Brazil
Burkina Faso
Cambodia, Phnom Penh
Colombia
East Timor
Ecuador (non-Quito)
El Salvador (San Salvador)
Ethiopia (non-Ababa)
Guatemala
Guinea
Honduras
India (Ahmedabad)
Indonesia
Israel (Jerusalem)
Kenya
Kosovo
Kyrgyzstan
Mauritania
Mexico (non-Guadalajara, non-Cancun, non-San Jose del Cabo, non-Veracruz)
Nepal
Niger
Papua New Guinea
Peru (Lima)
Philippines
Saudi Arabia

I have read and confirm that I can abide by this safety policy? *

Yes No I am confused and need more clarification I have a few questions pertaining to this policy

Please share with us why your company or organization is seeking to come on campus. *

Please explain the specific opportunities and locations that you are hoping to share with students and how that will add value to their college experience. *

How long do you intend to promote this opportunity at LU (please provide start and end dates) *

How long do you intend to remain on campus each day for recruitment (please provide start and end times) *

Please upload a current Copy or Certificate of your organization's liability/event Insurance (COI). *

Browse Files

Will you need a table/booth setup? *

Yes No

Where would you prefer to have your table set-up for recruiting? (Please list a 2nd and 3rd option for location)? *

What will you be bringing for set-up and/or promotional material? *

Please list the departments that you are seeking to connect and recruit from. *

Is there any other information or questions you have prior to coming on campus? *

Name of Prospective Guest: *

Twitter Handle *

Ex; @guest1

Proposed Honorarium: *

Relevance/Topic: *

Proposed Date *

What are alternate acceptable dates for your event? *

Audience: *

Estimated Attendance: *

Proposed Location: *

What are alternate acceptable locations for your event? *

How much time do you expect to need for set up? *

How much time do you expect to need for teardown? *

What time would you like your event to start? *

: Hour Minutes AM/PM Option

What time do you expect your event to end? *

: Hour Minutes AM/PM Option

How much do you have budgeted for this event? *

Proposed Hosting Meals Information: *

How many microphones and stands will you need for your event? *

Will you need access to the AV system in the room to hook up a laptop/phone? *

Yes No

Will you need a stage for your event? *

Yes No

What size stage would you like for your event? *

Will you need your event live-streamed? *

Yes No

Will it be streamed to Facebook live? *

Yes No

Would you like it streatmed to a room on Campus? *

No

Will you need an EP Sound/AV tech for your event? *

Yes No

What time would you like for them to arrive? *

Will you need a soundcheck for your event? *

Yes No

How much time would you like for a soundcheck? *

How many chairs will you need for this event? *

How many rectangular tables will you need? *

How many round tables will you need? *

Would you like table cloths? *

Yes No

Will your guests require any special parking considerations for this event? *

Yes No

How many special parking spaces will you need? *

Will you want any special decor for this event? *

Yes No

Will Pastor David, Pastor Josh, or President Falwell be attending the event? *

Yes No

Proposed Hotel: *

Proposed Transportation (Air & Ground): *

Type of Vehicle Picking Up: *

Have you contacted marketing to promote your event? *

Yes No

If yes, what is the plan to promote this event? *

OSD Prospective Guest Form

Department/School Information

Organization Details

Guest/Event Details

Travel Details

Promotion Details