JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
Chancellor Attendance Request
INSTRUCTIONS: Please complete all sections of this form. This information will allow the Chancellor's Office to address your event or meeting request more effectively. For best consideration, please include the Chancellor’s Office early in your planning process because the Interim Chancellor’s calendar tends to fill up very quickly.
Once Interim Chancellor Norris’ attendance to an event or meeting is confirmed, a detailed event brief will be requested 2 weeks prior to the event, as indicated in the confirmation email that will be sent. If final event or meeting details are not received by the Chancellor’s Office at least one week prior to the scheduled event or meeting, then the Interim Chancellor’s participation cannot be guaranteed and the event may need to be postponed or rescheduled at the Interim Chancellor’s discretion.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Name of requesting Organization, Unit, or Department and Address:
*
Your answer
For internal campus stakeholders, has this request been approved by the requesting division’s Vice Chancellor, AVC, or College/School Dean?
*
Yes
No
Title of Event
*
Your answer
Event Format:
*
Dinner
Reception
Lecture
Meeting
Luncheon
Other:
Required
Event Date and Time:
*
MM
/
DD
/
YYYY
Time
:
AM
PM
Event End Date and Time
MM
/
DD
/
YYYY
Time
:
AM
PM
Please provide any additional information about event date and time (If the Proposed Date/Time is flexible - list the other possible dates here so that those options may be considered as well):
Your answer
Location of Event (Describe Stage/Venue):
*
Your answer
Interim Chancellor's Role:
*
(Please describe)
Your answer
Describe the goals / objectives and desired outcomes of your event:
*
Your answer
Describe the audience composition, including honorees, VIPs, or key constituents. To your knowledge, will any members of the Appalachian Board of Trustees or UNC Board of Governors be invited?
*
Your answer
Will media be present or invited?
*
Your answer
Number of guests expected:
*
Your answer
Attire:
*
Evening Wear
Business
Business Casual
Other:
Remarks requested:
*
Yes
No
If yes, please indicate type, length, and subject matter of remarks requested:
Type - Welcome, Introduction, University Update, etc.
Your answer
Name of event liaison:
*
Your answer
Telephone number for event liaison:
*
Your answer
Email for event liaison:
*
Your answer
We require briefing materials and talking points 2 weeks before an event. Please indicate name of person who will be providing materials:
*
Your answer
Will the Interim Chancellor's name be used on printed materials? If so, material must be approved by Chancellor's Office prior to distribution. If yes, please send to
antonucciad@appstate.edu
*
Yes
No
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
This form was created inside of Appalachian State University.
Report Abuse
Forms
