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Chancellor Event Request

Chancellor Event Request Form

Requestor Information

First Name:

Last Name:

Requestor's Affiliation:

FacultyStaffParentOther

If other, please explain:

Campus Department and/or Title:

Email:

Phone Number:

Event Contact

First Name:

Last Name:

Phone:

Email:

Event Information

Event Name:

Topic/Purpose:

Chancellor's role in this event in detail:

Event Date:

Event Duration:

Time that Chancellor is requested to attend:

Specify location of event:

On-campus, specify on campus locationOff-campus, specify locationZoom video conferencingMicrosoft Teams video conferencing

Key participants, titles, and affiliations:

Estimated audience size:

Dress:

CasualBusinessCocktailFormal

Graphic, poster, or image:

Additional files if necessary:

Chancellor's remarks required?

YesNo

Any additional comments or requests:

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Boston, MA 02125
617.287.5000

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Chancellor Event Request Form