Dean's Office Invitation Request

First Name

Last Name

Title

Organization

Preferred Email

Phone Number

City

State

Country

Name of Program

What is the theme and/or purpose of the program? What are the desired outcomes?

Start Time

Please enter in a 12-hour format (for example 10:00 am)

End Time

Please enter in a 12-hour format (for example 10:00 am)

Address

Address 2

City

State

Postal Code

Country

Facebook

Instagram

YouTube

Twitter

Google+

Eventbrite

Other

Participant Information

Will a media advisory be issued? YesNo	If media shows up to the event, will they be allowed in? YesNo
How many media outlets do you predict will be in attendance (if any)? Noneless than 55 - 10 More than 10	Will this event be recorded or web-casted? YesNo
Will this event use social media? YesNo