Request Contact Name & Title Event Request Contact Name Event Request Contact Title Organization & Organization Website Request Contact Phone Request Contact Email Event Name Event Date Event Time Event Location & Address Parking Information If applicable Event Contact Name On Site Event Contact Phone On Site Event Purpose/Intention Event Audience Description Event Estimated Attendees Event Url or Website Please email any flyers ad pdf or jpg to [email protected] Event Role for Supervisor Lee Event Role for Supervisor Lee - Select -SpeakerPanelistKeynoteAttendeeHonoreeOther… Enter other… Additional Comments For Virtual/Online Events - Please provide link and additional details Leave this field blank
