First Lady Carolyn Boltin-Kelly Speaking & Attendance Request Form

Thank you for your interest in having First Lady Carolyn Kelly participate in your event.

All meeting and event requests are reviewed with the First Lady. In light of the demands on the First Lady’s time, it is not possible for her to accept all event requests. Therefore, we ask that all requests are made a minimum of 30 days in advance of your event. Responses to event requests will be received within 5 to 7 business days via email.

To assist us in serving your needs, please complete the form below:

If you see this don't fill out this input box.

*Contact Name

*Contact Email

*Event name

*Event date

Is the date flexible?

Yes No

If YES, please provide options

*Event start time

*Event end time

*Duration/Time frame of Mrs. Kelly's Attendance

*Event Location

Mrs. Kelly's Role

Guest Speaker

*Purpose or theme of the event and how Mrs. Kelly's attendance will contribute to the success of the event

*History of event

*Main message you want the audience to take away

*Number of guests expected

Describe specific audience and please attach guest list if one is available

Will there be food?

Yes No

Please describe the food options

Is there a cost for Mrs. Kelly and one guest to attend?

Yes No

If YES, please provide specifics

Any additional comments or information

Please submit any questions to Heather.Kurstin@fau.edu

Florida Atlantic University

First Lady Carolyn Boltin-Kelly Speaking & Attendance Request Form