Le Moyne College - Alumni Support Request Form

Alumni Speaker Request Form

First Name

Last Name

Primary Email

Requesting Department or Organization (if multiple, please list all groups)

Event Title

Event Location - Room Reserved

Proposed Event Date

Is this date flexible?

Event Time

Alumni needed for....

# of Alums needed

Event description & goal

Do you need alumni from a specific industry or major? If so indicate which ones.

High Profile Request (please provide name and brief Bio.)

Off-site Student Events

Student organizations looking to travel to a populated alumni area, please complete this section. NOTE: Three months of planning is required so plan accordingly.

Destination city

Means of Travel

Source of funding for trip

Moderator name

Moderator email address

Why a Dolphin?

Thank you for looking to partner with the Office of Alumni & Parent Programs!

All speaker requests should be made 6 weeks in advance of the proposed event date.

Please fill in the required fields and someone will follow up in 2-3 business days.

NOTE: If you are requesting a high profile speaker they should be contacted 3-5 months in advance.