Speaking engagement/event participation request form

To assist the president in serving your needs and representing Virginia Commonwealth University in the best possible fashion, please complete this form as part of any invitation for the president to speak at or attend an event or meeting. Please note that all fields are required.

While the president openly accepts the vast majority of invitations that are made, he must frequently decline an invitation due to a calendar conflict. The Office of the President attempts to accommodate most requests that support the mission of the university and appreciates your patience with the president’s complex calendar.

For more information, please contact Mandy Moffett at (804) 828-7498.

Event details

Event name:
Event location:
Event date:
Event start time:
Event end time:
Please indicate the timeframe/duration of the president’s presence:
What time will the majority of guests arrive?
Please note: The times requested for the president’s participation should be as exact as possible, as the president is often juggling multiple events in series. If the event schedule changes after submitting this request, it is the requesting department’s responsibility to contact Mandy Moffett at (804) 828-7498 immediately so she may determine if the change can be accommodated.
Dress code:
Is there a theme for this event?
If yes, what is the theme?
History of this event (inaugural, annual, etc.):

Contact information

Contact person:
Phone number:
Address:
E-mail (one address only):
Person who will meet the president at the event:

Audience profile

Please list whether the audience is internal, external, business, education, government, donors, etc. (please be specific):
Number of people expected
in audience:
Ages:
Is the audience:

Speaking engagement

Is the president being requested to speak?

Please submit an official copy of program/invitation to the Office of the President at least three (3) days in advance of event. Upload a PDF to this form or send or fax to:

Virginia Commonwealth University
Office of the President
P.O. Box 842512
Richmond, Virginia 23284-2512
Fax: (804) 828-7532
Upload a PDF of program/invitation:
What is the group’s interest in hearing the president speak?
Does the group have any special interests or concerns that should be addressed? If yes, please describe.
Is there a topic or subject that should be addressed in the president's remarks? If yes, please describe.
Should remarks be formal or conversational?
Preferred length of comments:
Are there people in the audience who should be recognized (dignitaries from group, politicians, donors, etc.)?
If so, who?
Are there any other speakers?
If so, who?

An e-mail confirming receipt of request will be sent to contact person listed on this form.

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Office of the President, Michael Rao, Ph.D.

Virginia Commonwealth University