Delegate Reply for Bassam M. Deeb, Ph.D. Presidential Inauguration
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1
. Our Institution will be represented by a delegate.
Our Institution will be represented by a delegate.
Yes
No
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2
. Our delegate will march in the academic procession.
Our delegate will march in the academic procession.
Yes
No
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3
. Name of Institution
Name of Institution
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4
. Year of Founding of Institution
Year of Founding of Institution
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5
. Delegate's Name [As you wish it to appear in the official program (first, middle, last)]
Delegate's Name [As you wish it to appear in the official program (first, middle, last)]
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6
. Delegate’s Title/Position/Relationship (e.g. alumnus, Trustee)
Delegate’s Title/Position/Relationship (e.g. alumnus, Trustee)
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7
. Delegate’s Highest Academic Degree
Delegate’s Highest Academic Degree
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8
. Delegate’s Business Address (Please include Street, City, State and Zip Code)
Delegate’s Business Address (Please include Street, City, State and Zip Code)
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9
. Delegate's Business Phone (Please include area code)
Delegate's Business Phone (Please include area code)
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10
. Delegate’s Daytime Phone
Delegate’s Daytime Phone
11
. Delegate’s Cell Phone
Delegate’s Cell Phone
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12
. Delegates E-mail Address
Delegates E-mail Address
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13
. A spouse or Guest will accompany the delegate.
A spouse or Guest will accompany the delegate.
Yes
No
If yes, please specify the name of the delegate's spouce/guest.
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