Meeting Request Form
Meeting Request Form
Meeting Request Form
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<strong>Meeting</strong> with President Ron Carter<br />
Scheduling <strong>Request</strong> <strong>Form</strong><br />
Please fill out this form completely.<br />
*Mtg Date: *Mtg Time: *Mtg Location:<br />
Date of <strong>Request</strong><br />
Employee of JCSU<br />
Yes No<br />
<strong>Request</strong>or/Contact Information<br />
<strong>Request</strong>or/Contact Name<br />
Company<br />
Department Phone Fax Email<br />
Address City State Zip<br />
Preferred <strong>Meeting</strong> Date:<br />
<strong>Meeting</strong> Title:<br />
Purpose of <strong>Meeting</strong> (Please Detail):<br />
<strong>Meeting</strong> Information<br />
Duration:<br />
Re-occuring: Yes No<br />
End date of series:<br />
Please List Objectives:<br />
Objective 1:<br />
Objective 2:<br />
Objective 3:<br />
Please List Intended Outcomes:<br />
Outcome 1:<br />
Outcome 2:<br />
Outcome 3:<br />
**Important** Please attach all relevant background information such as: program outlines and summaries, bios, profiles,<br />
websites and links, referrals, costs, expenses and organizational collateral<br />
<strong>Request</strong>ed &<br />
Confirmed<br />
Attendees<br />
(provide first,<br />
last name, title<br />
and connection<br />
to meeting)<br />
Name & Title Connection Confirmed <strong>Request</strong>ed<br />
1. Yes No Yes No<br />
2. Yes No Yes No<br />
3. Yes No Yes No<br />
4. Yes No Yes No<br />
5. Yes No Yes No<br />
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<strong>Meeting</strong> with President Ron Carter<br />
Scheduling <strong>Request</strong> <strong>Form</strong><br />
Catering, Coffee Breakfast, Lunch<br />
or Dinner<br />
Yes No<br />
Preferred Meal Selection:<br />
Equipment/ Other: LCD Projector Yes No<br />
Laptop Yes No<br />
AV Tech Yes No<br />
Conference Call # Leader Pin #<br />
Other:<br />
Off-Site <strong>Meeting</strong>: Yes No If Offsite, Preferred<br />
Location:<br />
Other Misc. Details:<br />
*Office Only<br />
Please return the COMPLETED SPEAKER REQUEST FORM via EMAIL to tscarborough@jcsu.edu or by mail to 100<br />
Beatties Ford Rd., Charlotte, NC 28216, attention Tori Scarborough. We appreciate your patience while we process<br />
your request and will inform the results to you as soon possible. Due to a high volume of requests to meet with Dr.<br />
Carter, we cannot guarantee your preferred meeting location and date. If you have any questions or concerns, please<br />
call Tori Scarborough at 704.378-1111.<br />
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