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Henry W. Bloch School of Management

Dean Appearance Request Form

Before completing this form, please contact Jill Masson at massonj@umkc.edu to check availability.


Requestors:*

Phone:*

Today's Date:*

Department/Organization/
Academic Unit:*

Requested Executive: Dean David Donnelly

 

Event Logistics

Event Date:*

Event Start Time:*

Event End Time:*

Event Title:*

Event Type:*

Location Name:*

Location Address:*

Attire:*

Dean Requested Arrival Time:*

Dean may leave by:*

On-Site Contact:*

On-Site Mobile Phone:*

Program Outline

Audience:*

Other University Leadership in Attendance:*

Other Notable Attendees:*

Please provide a basic outline of your event program:*

Speaking Request

Speech Length:

Speech Start Time:

Speech End Time:

Individual completing remarks:

Purpose and desired outcome:

Talking Points:

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