Student Government Speaker Request Form Name of Organization:* Contact Person:* First Last Phone Number:*Email Address:* My Organization is:* On Campus (TAMU main campus) Off Campus - B/CS Off Campus - Out of town Event InformationEvent for which speaker is requested:* Meeting Facility & Room#:* Address:* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Where should the speaker park?:* Date requested:* MM slash DD slash YYYY Time requested:* : Hours Minutes AM PM AM/PM Alternate date requested:* MM slash DD slash YYYY Alternate time requested:* : Hours Minutes AM PM AM/PM Presentation InformationWhat topic(s) do you want the SGA speaker to address?:* Approximately how long into the meeting will speaker be expected to make presentation:* Preferred length of presentation:* Q&A Included:* Yes No Accommodation InformationWill overnight accommodations be provided if needed?:* Yes No If the answer is Yes:* Local Hotel Organization Member's Home Name of Hotel or Organization Member Host:* Address:* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone Number:*Host's email address:* MiscellaneousPlease type any additional information that you would like us to know: