Meeting Request Form

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