Presentation Request Form

Please submit a presentation request three weeks in advance of your preferred date. If you have questions, please contact Student Outreach and Support at sos AT_TOWSON

Section

Name of person requesting program:

E-Mail of person requesting program:

Phone Number of person requesting program:

Department or Organization requesting program:

What is your position in the department or organization?

Who is the intended audience?

What topic(s) would you like to have included in the presentation?

Please estimate the duration of your program:

1st Preferred Date (please choose date 3 weeks in advance of request):

2nd Preferred Date:

3rd Preferred Date:

Preferred Time: (Please indicate AM or PM)

Place/Location:

Number of attendees expected (we ask for a minimum of 10 audience participants):

Is there presentation equipment at the location of the event (i.e., computer, projector, etc.)?

YesNo

Is there microphone and speaker access as some presentations have a video component?

YesNo

Is the presenter able to arrive early to set up?

YesNo

Additional comments/information regarding your request (describe your audience):