Dean's Speaker External Request Form (virtual appearances) While social distancing and other COVID-19 events remain present, the CLASS dean will still be available to speak, but all events will be held in a virtual format. Due to the many demands on the dean’s time, we request that you submit this form so that he can manage the commitments and schedule his participation. This form will assist our staff in coordinating the dean's participation at your event. This is a two-part process. You must complete this step prior to completing the final event details. *Denotes a required field - We will contact you should there be any questions regarding entry of your event In order to best accommodate your request, please submit the requested information at least 4-6 weeks prior to the date of the event. If your request is accepted by Interim Dean Daniel P. O'Connor, you will be contacted in 7-10 business days. Contact Information of Requester *First Name: *Last Name: *Business Phone Number: *Mobile Phone Number: *Email: *Name of Organization: *Organization's Web Address: How will the event be held? (please include contact link) Zoom Teams Webinar Telephone conference call Other Event Information: *Title of Event: *Date of Event: *Number of participants expected: *Start Time: *End Time: *Type of Event (e.g. lecture, workshop, conference, panel discussion, etc.): Full address of Location, if applicable: *Sponsored by: *Are there any dignitaries/elected officials involved in this event?: Yes No If yes, please list elected officials by name and title: Please send event flyer, brochure, poster, and other supporting marketing collateral to UH CLASS Communications. Event URL: Desired Role of the Dean (select one) Speaker - Welcome Remarks (3-5 minutes) Only Speaker - Brief Remarks (less than 15 minutes) Speaker - Keynote address (15 minutes or more) Panel Participant Interview or Q&A Closing Remarks Other *Objective/Purpose of Event (Describe in one or two paragraphs): Audience Composition (please check all that apply): Students Faculty Staff Alumni Business Leaders Community Members Members of your Organization/Board of Directors Elected and/or Government Officials Other (please list in box below)