First Lady Participation Request Form To assist the president's office in managing First Lady Jai Vartikar’s busy calendar, we kindly request that you complete this form at least four weeks prior to the requested date to initiate your request. The First Lady strives to accept as many invitations as possible, but unfortunately, she must decline some requests due to scheduling conflicts. The president's office attempts to prioritize requests that support the mission of Florida State University. If your request is approved, we ask that you submit briefing materials to our office at least two weeks prior to the confirmed date. Name* First Last Email Address* Phone Number*Primary Affiliation*Please SelectFSU FacultyFSU StaffFSU StudentFSU Direct Support OrganizationFSU AlumnusFSU ParentCommunity or OtherTitleDepartment or College or Unit*Does this request have the approval of the director, dean or department head?*YesNoFSU Direct Support Organization*AlumniFoundationBoostersReal Estate FoundationRinglingCommunity or Other*I would like to*Request a meeting with the First LadyRequest the First Lady record a videoRequest the First Lady’s attendance at an eventMeeting InformationMeeting Type*In personVirtualPhone callPurpose/Topic*Desired date range*Other attendees*Additional CommentsVideo InformationEvent Title*Date* Date Format: MM slash DD slash YYYY Location*Description of Video*Script Contact*Event InformationContact Person*Event Title*Date* Date Format: MM slash DD slash YYYY Start Time* : HH MM AM PM End Time* : HH MM AM PM Location*Attire*First Lady Role Request*Description and Historical Background of event*Estimated Number of Attendees*VIPs attending* FSU Donors Board of Trustees Members Board of Governors Members Elected Officials International Dignitaries Other First Lady’s role*Attend onlyPhoto OpGive remarksGive remarks*Brief remarks (2-5 mins)Short remarks (5-10 mins)Speech/Keynote address (15-20+ mins)Remarks Contact*Key Talking Points*Who will introduce the First Lady?*List other speakers and program order*Is the media expected to attend this event and if so, has University Communications been contacted?*YesNoAdditional CommentsCommentsThis field is for validation purposes and should be left unchanged.
