Paul Simon Public Policy Institute Event Inquiry Form

Please review and fill out the following questions.

If you have questions about the form or our event process, please contact Associate Director, Carol Greenlee at cgreenlee@siu.edu or 618-453-4001.

*Please note that event inquiries must be submitted at minimum 30 business days prior to the requested event date for consideration.

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* 1. Today's Date

Date / Time

Date

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* 2. What type of event are you inquiring about?

New Event with the Institute

New Event with Institute as only as a co-sponsor

Speaking Request for Institute Director John Shaw

Speaking Request for Visiting Professor Dr. John Jackson

Speaking Request for Dr. Linda Baker

Other (please specify)

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* 3. Proposed Event Date & Start Time:

Date / Time

Date

Time

AM/PM

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* 4. Event Name:

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* 5. Event Location:

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* 6. Estimated Event Cost:

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* 7. Anticipated Head Count:

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* 8. Draft agenda or program outline available?

Yes

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* 9. If yes, please upload a copy:

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* 10. Please describe the event by including a program description, names of speakers and links to websites for verification.

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* 11. General Marketing Needs:

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* 12. General Catering Needs:

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* 13. General Media/Audio requirements? (i.e. microphones, PowerPoint, etc.)

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* 14. Contact Person Information:

Name

Title

Company/Organization/Department/RSO

Email Address

Phone Number