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Speaking Requests

Invite the Provost to your event

Thank you for requesting Provost & Vice-President (Academic) Florentine Strzelczyk to speak at your event. Please first contact Gayle Stuebing at (519) 661-3109 or email gstuebin@uwo.ca to determine if the Provost is available on the date of your event. Once the Provost's attendance at your event has been confirmed please complete and submit this form.

* = required fields

Your Contact Information

Name: *
Job Title: *
Department: *
Phone Number: *
Email: *

Event Details

Name of Event: *
Primary Objective: *
Event Date: *
Event Venue: *
Speech Setting (ie: Stage, Podium and Microphone, Casual): *
Provost's Arrival Time: *
Proposed Agenda, including list AND ORDER of other speakers *
Audience Composition and Size *

Is this an annual event: *

Is this an alumni or donor relations event: *

Will there be government officials in attendance: *

If yes, please provide names and titles:

Speaking Requirements

Purpose of Speech *
Expected Length of Remarks or Speech *
Who will introduce the Provost (Name and title) *
Individuals to be acknowledged in speech: *
Key messages you would like the Provost to deliver: *

Logistics

Parking Arrangements: *
Dress Code *

Who will greet the Provost?

Name: *
Cellphone Number: *
Email:*

Background

Other important background information about event that should be mentioned: *

Provost Bio