Regional Clubs
(Global Alumni Network)

Speaker requests are due at least 3 months in advance of your proposed alumni event.

By completing and submitting this request form, I/we accept and understand the requirements of our Penn Alumni Club as outlined in the Global Alumni Network Speaker Guidelines document in order to partner with Alumni Relations in bringing a Penn speaker to our club.

Name

Email

Alumni Relations staff contact

Club/Group name

Location of club

List any recent speakers that have addressed your group, along with the date of the event

Additional information about your club/group (e.g., typical events, signature events of note, demographics, how often you meet, how often you host speakers)

Your preferred timeframe for hosting a speaker is
 Fall Semester  Spring Semester  Summer

Is there a preferred month/week/day that you would like a speaker? If so, please list your preferred dates in order of preference
1.
2.
3.
4.

Please list any dates that you CAN'T host a speaker (including any school/religious holidays, dates of other club events, etc.)


Type of event (e.g., dinner, cocktail reception, seminar)


Proposed length of talk


Proposed nature of talk (e.g., lecture, discussion, Q&A)


Expected event attendance

If you have a specific speaker to request, please list that here in order of preference. If instead you are looking for someone from a specific school/department or would like someone to talk about a specific topic, list that in your preferences. Please list at least two choices.

First choice

Second choice

Third choice


Requested topic (e.g., you'd like someone from the History department to discuss the Civil War)

Day trip or overnight

Mode of transportation proposed

Club/Group deadline (e.g., print deadline)

Please provide any other information you think would help make this request successful