CEO Scheduling Request Form

Please complete this form as part of any invitation for our CEO, Margaret Mitchell to speak at or participate in an event.

Requestor's Name

First Name

Last Name

Requesting Organization

Organization Web Address

Type of Request (Speaker, panelist, attendee, supporter, etc.)

Event Title

Date

YYYY

Time (duration)

Estimated # of Attendees

Purpose/Mission

What can YWCA USA contribute to make this event a success?

Onsite Point of Contact (Name/Phone/Email)

Will A/V be provided?

Yes

Presentation Title

Presentation Speaking Duration

Individuals to recognize in presentation (Name/Organization/Title)

Will travel/expenses be covered

Yes

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