Event Notification Request Form

1.	Person Requesting*

2.	Department/School*

	Event

3.	Title of Event*

4.	Event Description

5.	Date of Event*
	mm/dd/yyyy

6.	Event Time*

7.	Location of Event*

8.	Have you requested a facility?
	--None--Yes No

	Audience

9.	Number of Participants

10.	Event on District Calendar?
	--None--Yes No

	Details

11.	Linda Ellis to Speak?*
	--Please Select--Yes No

12.	Has she been notified?
	--None--Yes No

13.	If yes, how:

14.	Will the School Board need invitations?
	--None--Yes No

15.	Will City/State Officials need to be in attendance?
	--None--Yes No

	Social Media/AV Support

16.	Please select what support you may need: Select at least 0 and no more than 0.
	Social Media    Audio/Visual    Photos    Other, please specify

	Media

17.	Media Expected?
	--None--Yes No

18.	Do you need a Press Release?
	--None--Yes No

	Meeting Collateral

19.	Please select items needed: Select at least 0 and no more than 0.
	Powerpoint    Flyer    Brochure/Agenda    Invitation

20.	Technology Needs:

	Contact Person that Will Oversee the Event

21.	Name:*

22.	Position:

23.	Department/School:

24.	Campus/Site Phone Number:

25.	Cell Phone Number:*