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* 1. Your Name

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* 2. Organization

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* 3. Your Email

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* 4. Your Phone

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* 5. Name of Event

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* 6. Venue Address (include street, city, and zip code)

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* 7. Event Date

Date
Time

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* 8. RSVP By Date

Date

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* 9. Expected Audience Size

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* 10. Event Purpose

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* 11. Proposed Guest Speaker Please provide the name of the staff member you would like to invite. If you do not have a specific person in mind, please specify the department or unit you would like to represent.

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* 12. Role of the requested guest

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* 13. Discussion Points List all the topics you'd like the presenter to cover.

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* 14. Will other speakers be invited? If yes, please list their names.

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* 15. Additional Information

T