Corporate Interaction: Presentation Request

Name and Contact Information of Student Representative (if any)
Student Representative Name
First Last
Student Representative Email (If known)
Student Representative Phone (If known)
Further Information
Email of Person Completing This Form (You!)
Corporation Being Represented
Affiliated UGA CVM club, if any
Presentation Details
Title of proposed presentation
Speaker's job title and qualifications
Rationale for making the presentation to UGA CVM students
Outline of presentation
Food or gifts to be provided to all attendees (see Guidelines for gifts and food intended for human consumption within the UGA CVM Corporate Interaction Policy)
Date being requested for presentation
Date Format: MM slash DD slash YYYY
Time requested

: HH

MM
Location requested
By signing below, I agree to comply with the UGA CVM Corporate Interaction Policy
Signature
Date
Date Format: MM slash DD slash YYYY
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Name and Contact Information of Student Representative (if any)