ESR Speaker Request Form

Who will introduce Speaker(s)? Name: Title:

If available, what is the speaker's agenda?
(Example: "Speaker arrives at Ballroom 1 at 8:15 a.m. for sound check. Speaks from 8:30 -9:30 a.m. Can leave after 9:30 a.m.")

Will there be any elected officials participating/attending (if yes, who)? Yes: No:

Will any press or media attend the event (if yes, who)? Yes: No:

Will expenses be paid up-front or reimbursed? Up Front: Reimbursed:

If the event requires ground transportation, will you be making arrangements on our speaker's behalf: Yes: No:

Any other schedule considerations or additional notes?
(Example: Do you plan to invite the speaker to a reception before the speaking engagement or afterwards? If so, location of the reception? Reception attire?)