Request the CPE President at Your Event - Details Form

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

Please fill this form out only if you have received confirmation that the CPE president can participate in your event. To make the initial request, use the event inquiry form.

If you have questions or have problems submitting this form, contact the president's office at 502-892-3194.

Person making the request

*Name

*Organization

Job title

*Email address

*Phone number

About the event

*Name of event

*Date

Please specify the date for Dr. Thompson's active participation.

*Start and end time with time zone:

*Type of event:

Based on your answer above, please provide the appropriate details.

If In-Person

IF IN-PERSON -> Location of event:

Please include the city and state to help us figure in travel time.

IF IN-PERSON -> Parking arrangements:

Please let us know where Dr. Thompson should park and if a fee is associated with it.

IF IN-PERSON -> Who should Dr. Thompson ask for when he arrives at the venue?

If Online

IF ONLINE -> Credentials for Dr. Thompson to participate in the event:

The link and/or username/password Dr. Thompson needs to participate in your event. If using a platform other than Zoom or MS Teams, please specify the product and the download link, also.

IF ONLINE -> Credentials or registration information for CPE staff supporting Dr. Thompson

This is how CPE staff can participate in the event as viewers.

If Requesting a Submitted Video

IF SUBMITTED VIDEO -> Date video needed

This is the due date for us to get the video to you.

For All Event Types

*FOR ALL EVENT TYPES -> In case of emergency contact

If Dr. Thompson is held up traveling to your event or has another issue that affects his ability to get there, please let us know who he should contact.

*FOR ALL EVENT TYPES -> Phone number to call in case of an emergency

Number of the person indicated above.

To help us prepare Dr. Thompson

Role for the president

Expected number in audience

This can be an estimate based on invitees.

*Type of people attending your event

Please provide the type of people (either demographics or positions) attending the event.

Type of attire

Help us advise Dr. Thompson the formality of the event.

*Brief description

Please tell us a little about the event.

Presentation specifics

If Dr. Thompson is speaking or a panelist, please let us know the areas he's to cover in his remarks.

Is there technology available if Dr. Thompson chooses to supplement his remarks with a Powerpoint presentation?

YesNo

*Do you expect the media to be in attendance?

YesNo

Last Updated: 9/14/2021