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President's Attendance Request Form

President's Attendance Request Form

To request President Keshen's attendance at your event, please complete the form below.

Title of Event * Event Date * Event Time * Contact Name * Contact Email * Contact Phone Number (work) Contact Phone Number (cell) Location and Room Number * Address Parking Availability * Description (topic, audience, order of program, speakers and emcee if known), etc.) * Anticipated Number of Guests * Anticipated Dignitaries/Special Guests; Pronunciations and Formal Titles (if appl) * Role Requested (general welcome, opening remarks, keynote address, etc.) *

If the President is unavailable, are you seeking a designate? * Yes No

Length of remarks * Please provide 3-5 points/themes that would be of interest to your audience (as detailed as possible) *

The University of Regina collects information under the authority of The University of Regina Act and in accordance with the Local Authority Freedom of Information and Protection of Privacy Act and the Personal Information Protection and Electronic Documents Act for purposes of the administration of the University and its programs and services. By responding to this form, you are consenting to the University of Regina using your personal information to respond to your request.