Questions marked with an * are required Exit Survey
 
 
Thank you for interest in having SVA at your event.  In order to best respond to your request, Please fill out this web form completely. All boxes must be filled. If a question does not apply to your request, please put N/A.If it does not apply please put N/A.  You will be given an opportunity at the end of the form to upload any documents (formal letters, fliers, agendas, bios, etc.) about the event.  

For any questions about the form, please contact Mae-Beth Legeyt, Executive Assistant, at maebeth.legeyt@studentveterans.org
 
 
 
Sponsoring Organization Information
 
 
Sponsoring Organization *
   
 
Please provide the contact information for request:
First Name *  : 
Last Name *  : 
Address 1 *  : 
Address 2 (if not applicable put N/A)    : 
City *  : 
    State *     Zip *
Phone (xxx-xxx-xxxx) *  : 
Email Address *  : 
 
 
Contact Position: *
   
 
 
Organizational URL: *
   
 
 
Event / Presentation Details
 
 
Title of Event / Program: *
   
 
 
 
URL / Website for Event: *
   
 
 
 
Event: Start Date *
MonthDayYear
  
 
 
Event: End Date *
MonthDayYear
  
 
 
Location of Event:
Address 1 *  : 
Address 2 (if not applicable, put N/A)    : 
City *  : 
    State *     Zip *
 
 
 
Theme / Purpose: *
   
 
 
 
Requested SVA Speaker: *
   
 
 
 
Proposed Presentation Topic: *
   
 
 
 
Date and Time of Speaker's Presentation:   *
MonthDayYearHrs.Mins.AM/PM
    
 
 
 
Length of Speaker's Presentation: *
 
 
 
Format of Presentation *
 
 
 
Audio / Visual Capabilities *
 
 
 
Key Participants or Guests *
   
 
 
 
Target Audience *
 
Student Veterans
 
Non-Student Veterans
 
Campus Administrators
 
Campus Faculty / Staff
 
VSO's
 
Business Leaders
 
General Public
 
Other
    

 
 
 
Approximate Size of Audience *
 
 
Please provide any social media (e.g. hastags, Instragram accounts, etc.) connected with this event.
 
Hashtag
Instragram
Twitter Account
Facebook Account
 
 
Will media be covering this event? *
 
Yes
 
No
 
Unsure
     |  
Please completely fill out this web form. All boxes must be filled. If a question does not apply to your request, please put N/A.

For any questions about the Speaker Request Form, please contact Mae-Beth Legeyt at maebeth.legeyt@studentveterans.org