1. Name:

2. Email:

3. School:

4. Graduation Year:

5. Affiliation:

6. Which topic(s) would you like to hear discussed on your campus?

7. Which AEI scholar would you like to request to make this event happen? Feel free to consult our online list, http://www.aei.org/scholar/. Please list more than one.

8. Describe your thoughts on the setting and timing for this event. What will it look like? How many will attend? What date/time of year are you considering?

9. What student groups, organizations, committees, or departments would you collaborate with to make this event a success?

10. Describe in a few sentences why you think that this particular topic is important to bring to your school.

11. Record of success – please describe past successful events organized by this group.