Student Leader Request Form

Requestor’s Name * Required
Requestor’s Email Address * Required
Phone * Required
Requestor’s Department/Organization * Required
Event Name * Required
Nature of Event/ Purpose * Required
Date (s) of Event - must be mm/dd/yyyy format
Date Format: MM slash DD slash YYYY
Arrival Time for Event

: HH

MM

AM/PM
Location (If off campus please list address)
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Duration of Student Leader Appearance?
Duties/ Responsibilities (Greeter, Introducing speaker, tours, etc...) * Required
Specific Leader (s) Requesting (SGA, Royal Court, FYE, CA, General, etc)
How many students are you requesting?
Specific Attire
Are there any other essentials needed? Please provide details

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