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Please fill out this form at least two weeks in advance of the event. For more information, please contact Shannon Italia at or (904) 620-2067.

Event Information 

Requesting Organization

Requester's Relation to College?

Name of Event?

Date of Event?
 [None] Select a Date Delete the Date
Event Start Time?
Event End Time?
Dean's Role?
Time Frame/ Duration of the Dean's Attendance:
Location of Event?

Purpose of Event?

History of Event?
Will there be other speakers?

Describe the unique strategic contribution
of the dean's participation, providing context 
for how it will enhance your programs success:

Audience Information

Description of audience, including invited VIPs:

Number of Guests Invited:

Number of Guests Expected:

Will there be food provided?


Event Owner

First Name: 

Last Name:



Email Address: