Presidential Appearance Request Form

For a speech, appearance or event.

Thank you for your interest in having the president appear at your event. This form is used to request appearances and speeches for the President of Purdue University. Please submit the form online at least eight weeks prior to the event. All requests will be considered and responded to in a timely manner. Online submission of this form is REQUIRED for all requests. If you have questions about the form, please e-mail us.

Thank you for your cooperation.

* denotes a required field

Name of event *
Sponsoring organization *
Contact person *
Email *
Website
Office phone *
Cell phone *
Fax
Due to the president's schedule, not all requests can be accepted. If the president is not able to attend your event, would you like to have your request submitted to the Purdue Speaker's Bureau for an alternate suggestion?
Event start *
:
Event end *
:
If the date requested cannot be met, please suggest alternative dates
Description of event *
Why do you want the President to attend? *
Would you like the president's spouse to attend? *



Please attach a PDF of your program or event invitation
Expenses of event charged to
Audience - expected guests *
Expected attendance *
Attire *
Event location *
Location of event parking
Host(s) *
Host(s) phone *
Would you like the President to make remarks? *






Topic of remarks
Will there be other speakers? *
If so, who and in what order will they speak?
Are there dignitaries in the audience?
If so, who?
Are the press/media expected to attend? *
If so, which media organizations will be represented?
Are there notable Purdue alumni in the audience?
If so, who?
Audio / Visual Needs

For on-campus engagements, please contact Tim Todd, ttodd@purdue.edu, from the Hall of Music for audio-visual needs.

For events off-campus, please briefly describe available equipment (e.g. podium, sound system, etc.).
Additional notes or comments