Request for Chancellor Milliken to Speak

Thank you for completing this form, which will allow the Chancellor to quickly consider your request. The speaking engagement is not confirmed until you receive a separate email with confirmation.

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Name of Host Organization

Contact Name

Phone Number

Email Address

Is requesting organization a unit or department within a UT institution?

Name and Title of Person who Authorized Request

Requestor Information

Event Title

Location of Event (please notate if virtual)

Attire:

Date

What is the date of the speaking event?

Event Start Time

Event End Time

Requested Length of Chancellor's Remarks in Minutes

Estimated Number of Participants

Brief Description/Purpose of Event

Brief Description of Audience

Topic/Key Message

Identify Proposed Order of Program (list the speakers and order of timing)

Event Information

If Chancellor Milliken is able to participate, we respectfully request that you be available to provide us with assistance along the way.

Office of the Chancellor

Request for Chancellor Milliken to Speak

Requestor Information

Event Information