Event Date Request
Is your event date contingent on the availability of the Superintendent or Board Member? Or will the Superintendent or a Board Member be a part of the program, whether as a speaker or to provide awards?
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Yes
No
You indicated you do not need the Superintendent or Board member to serve as a part of your program; do you want to request they attend if schedules permit?
Yes, Superintendent and Board
Yes, Superintendent Only
Yes, Board Only
No
Are you a community organization who is requesting Mr. Hendrick or a Board member to attend your invite only event?
Yes, Community Organization.
No, I represent PCSB or Pinellas Education Foundation.
Name of Person Requesting Event
*
First Name
Last Name
Email
*
example@example.com
Department or Organization
*
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Event Name/Title
*
Brief description or purpose of the event.
Event focus or primary audience
*
Please Select
Students
Employees
Community
Date and Time of Event
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Event Type:
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In-Person Only
In-Person with Live Broadcast
Video Message
Approximate Length of Event
*
Hours and minutes
Event Location
*
School/ Location Name
Street Address
City
State
What role will the Superintendent serve as this event? Check all that apply.
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Attend only
Attend, participate and provide recognition (handshake, provide certificates, photo, etc.)
To bring greeting or welcome (2-3 minutes)
To be the keynote or featured speaker (5-15 minutes max)
To close the event (1-2 minutes)
No representation needed
Do you need Board member participation, if so, please indicate in what capacity?
*
Attend only
Attend, participate and provide recognition (handshake, provide certificates, photo, etc.)
Attend and bring greetings (2 to 3 minutes speaking).
No representation needed
Attend, bring greetings AND participate in program (handshake, certificates, etc.)
Please provide 3-5 key points to be included in the speech. NOTE: These items should be exclusive to this speech and not included in other speakers talking points.
If virtual event – will their remarks be live or taped?
Remarks Live
Remarks Taped
Do you need support from Strategic Communications for this event?
*
Yes
No
Submission Date
-
Month
-
Day
Year
Date
Submit
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