CW2024 - EVENT REQUEST FORM
Thanks for contacting the Cornel West for President campaign. Please fill out the below event request form, and someone will get back to you soon.
Sign in to Google to save your progress. Learn more
Were you referred by someone from the campaign? If so, who?
First Name *
Last Name *
Contact Email *
Contact Number *
Mailing Address
Your Work Title *

What is the official/legal name of the organization producing event?

 *

Please specify the event type or explain what capacity his attendance is requested? (i.e. political guest, fundraiser, meet & greet, rally, etc.)

*check all that apply

 *
Required
If Dr. West isn't available, can a campaign rep or surrogate participate in his place? *
If "Yes" to the question above or "Maybe" please list or explain.

Website

Primary Event Contact (if not yourself)

Event Date (Can be a specific date, date range, or “As Available”)

 *

Event Time (Can be a specific time, general time of day, or “As Available”)

 *

Event City

 *

Event State

 *
Is the event in person or virtual *

Name of Event Venue

 *

Street Address of Event Venue

 *

Event Title

 *

Event Theme

 *

Requested Topic 

 *

Event Platform

Anticipated schedule

 *

Tell us about your organization

 *

Tell us about your audience

 *

Approximately how many attendees do you anticipate?

 *

Will tickets be sold?

 *
Required
Please list any other public figures or talent you plan to incorporate into the programming
Please list any other public figures or talent who have appeared at your past events
Will the event be professionally audio, video and/or photographed?
Clear selection
If the event will be professionally recorded, will you be able to share the materials with the campaign in a timely manner (under 1 week)? 
Clear selection
Are there any sensitives to be considered in Dr. West's remarks? (words or topics that may have in community meaning/triggers/harm we should be aware of)
Is there anything else important for us to consider in this request that we haven't asked? 
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Cornel West for President. Report Abuse
Google Forms