Speaking Engagement Request: Shirley V. Hoogstra, President, CCCU

Thank you for expressing an interest in scheduling President Shirley V. Hoogstra to speak at your event. President Hoogstra loves the opportunity to deeply engage with conference participants and audiences. Her genuine love for people, and her keen focus on the importance of Christian higher education are evident as she speaks.

President Hoogstra's speaking engagement calendar tends to fill very quickly and very far in advance. Please complete this brief Speaking Engagement Request form. If there are a few items that you do not know at this time, you may come back at any time to edit or update your responses as long as you access the form from the same computer. President Hoogstra reviews incoming requests on a monthly basis.

Once you have completed the request form, please contact Emily Baldwin, Executive Assistant to President Shirley Hoogstra at ebaldwin@cccu.org or direct phone 202-552-3975 to confirm that a request has been submitted.

Thank you.

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* 1. Name of Organization

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* 2. Name, phone (office and cell), email and snail mail address of event contact:

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* 3. Organization address and website

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* 4. Event Title:

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* 5. Date(s) of Event:

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* 6. Type of Event:

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* 7. Event Start Time:

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* 8. Event End Time:

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* 9. Event Location

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* 10. Length of Speech/Presentation:

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* 11. Anticipated number in attendance:

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* 12. Audience profile and Age group of audience, interest, focus of the event:

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* 13. Theme or topic to address:

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* 14. In addition to the theme/topic is there a specific Bible verse, quote or other organizational reference for the event?

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* 15. If this is a panel or forum:   Is President Hoogstra acting as a panel participant or moderator? Please list the names of the other panel participants if available.

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* 16. If you will need items in advance (bio, picture, PowerPoint slides, written materials, etc.), please list the items needed and the date the item is required.

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* 17. Is regalia required for this event?  

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* 18. Media equipment available:

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* 19. Expenses covered by requesting institution:

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* 20. If an honorarium is offered, please indicate the amount:

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* 21. Contact Name, email, and address of person who should receive receipts/reimbursement requests for expenses.

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* 22. Will round-trip ground transportation from the airport to the hotel/event location be provided?  If so, please list driver/company details:

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* 23. Hotel/Lodging Details/Recommendations:

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* 24. Closest or most accessible airport or train station: 

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* 25. Misc. Details/Notes

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