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THAN 4 WEEKS PRIOR TO YOUR EVENT
Chancellor’s Event Attendance Request Form
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Complete all sections of this form; use attachments if necessary. Submit multiple dates or months in which the event may take place, if possible. Submit your Event/Speech Forms and Checklist, pre-approved by your AVC, NO LATER THAN 4 WEEKS PRIOR TO YOUR EVENT. Other checklists and forms may be found at http://emp.ucr.edu/chancellor.
Requestor Name/email/phone:
EVENT LOGISTICS
Name of Meeting/Event:
Requested Date(s): / Day(s) of week:
Time: / Start: / End:
Location/Venue:
On-site Staff and Contact Info:
Email and Phone:
Attendance Requested For: / Chancellor / Associate of the Chancellor / Executive Vice Chancellor
# of Guests expected: / Attire:
EVENT DETAILS
Reservation/Registration required? / Yes No
Tickets/Passes required? / Yes No
Seating Instructions:
Event Format (meeting, reception, dinner, etc.)
Room Set-Up (tables, theater, etc):
Parking Instructions/Special Permits:
Other travel arrangements? (airfare, etc)
Have these arrangements been made? If not, who will make arrange the details and notify our office?
Purpose of Event (goals, objectives, desired outcomes):
Describe the Audience: including names of honorees, elected officials, student groups and key constituents
CHANCELLOR REMARKS
IF REQUESTING CHANCELLOR'S REMARKS, PLEASE ALSO FILL OUT THE SPEECH REQUEST FORM THAT FOLLOWS.
Requesting Remarks? / Yes / No
If yes, please specify: / Brief: 5 min or less / Major: 6 min or more
The following require approval or notification: / Yes / No
Will a member of Congress, the state legislature, or other elected officials be involved?
Are UC Presidents or Regents involved?
Is media coverage expected?
Is a campus or community dignitary being formally recognized or honored?
Is this event of campus-wide significance (ground breaking, anniversary,…)?
Is this a development event (Donor recognition, Alumni …)?
Requesting Unit: / A&CR DEV OSC VCUA / AVC Approval received?
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THAN 4 WEEKS PRIOR TO YOUR EVENT TO: / Cindi Anderson,
CC: YOUR AVC
Vice Chancellor Approval / DO NOT WRITE IN THIS AREA
Speech Request Form
Program Context: Where does the Chancellor fit into your event? (ie: introduction, middle, keynote)
Who is speaking before/after the Chancellor?
Is there a Master of Ceremonies? If so, who? What is their affiliation with the event?
Who will introduce the Chancellor? Provide their full name and title. The Chancellor’s Bio can be found at http://chancellor.ucr.edu/about/bio.html
Will the Chancellor introduce anyone? Provide their full name, title and a short bio to assist in the introduction.
Will the Chancellor be asked to acknowledge audience members? E.G. speakers, organizers, campus affiliates such as alumni, donors or politicians?
Provide full names, titles and a pronunciation guide for anyone the chancellor will be acknowledging.
What are the main SPECIFIC points that the Chancellor should address for this particular event?
What is the message you wish him to convey?
Provide examples, suggested remarks or detailed talking points for his consideration.
What is the history of the event in relationship to the University of California, Riverside?
Is this a first time event or an annual event?
First Time Annual, since approximately
How does this event further the goals of the University? (ie: promoting education, developing community relationships, furthering research goals, scholarship cultivation)

.
If you have provided information on the event or speech form, check the box.
Otherwise, include the appropriate information/document(s).
CONTACT INFORMATION
INFORMATION BELOW WILL BE PROVIDED BY UNIVERSITY ADVANCEMENT IN A FULL BRIEFING
/ Meeting/Event Point of Contact:
/ UCR Point of Contact:
GENERAL MEETING/EVENT DETAILS
/ Name of Meeting/Event:
/ Date/Time:
/ Location/Venue:
/ Program:
/ Agenda:
/ Purpose:
/ What is the Chancellor's overall role? What is he specifically expected to do?
/ Number of attendees:
/ Names of key participants (delegates, donors, alumni, honorees, speakers, award recipients, etc.):
/ Bios for key participants
/ Background on organization hosting event, award, scholarship, initiative, etc.:
/ Attire:
/ other important information that the Chancellor should be aware of:
LOGISTICAL DETAILS
/ Directions/maps to and from one place to the next INCLUDED/ATTACHED
/ Parking Instructions/Special Permits INCLUDED/ATTACHED
/ Special travel arrangements (airfare, lodging, etc.) RESERVED
/ Required Reservation/Registration arrangements INCLUDED/ATTACHED
/ Event Tickets/Passes INCLUDED/ATTACHED
/ Seating instructions INCLUDED/ATTACHED
/ Room set-up (Round tables, banquet, theater, etc.) INCLUDED/ATTACHED
SPEAKING DETAILS (For events only)
/ Talking points (bullets or outline)
/ Podium usage? If so, where will it be located?
/ Type of microphone? (If Chancellor is speaking, he prefers a lapel mic)
/ Who will introduce the Chancellor?
/ How long is the Chancellor expected to speak?
/ Special acknowledgements that should be included in Chancellor's talk
/ Who will the Chancellor introduce or hand the microphone off to?