Appearance Request Form

Email Secondary Email

There are errors with your form submission. Please review and submit again

Requester Contact Information

Email address *

First name *

Last name *

Address 1 *

City *

State *

ZIP Code *

Primary Phone *

Cell/Other Phone

Organization Info

Organization *

501(c)(3) Federal E.I.N.:

Year Established

Organization Type *

Website

Organization Event Details

UB Coaches will not be able to speak at or participate in any type of high school, prep school, or athletic team fundraising activity.

Event Name *

Description *

Event Date *

Event Location *

Number of Guests *

Age Range of Guests *

Event Sponsor/Underwriter *

If no event sponsor/underwriter, please write N/A

Appearance Details

Requesting *

Coach Student-Athlete Athletics Staff

Requested Representative

Athlete/Representative(s) requested (in order of preference)

Dress Code

Business Formal Business Casual Casual

What will the representative be doing? *

Event Time and Length *

Please include start time and appearance end time. Standard appearance time limited to ONE hour in length

Event Address *

City *

State

Zip

Parking details for event *

Fundraising *

Are funds being raised at this event? If yes, what organization entity will receive them?

Event Advertising *

Will the representative's name, picture, personal appearance or involvement be used in any advertising or promotion of the activity? If yes, please describe.

Event Benefits *

Please include any benefits to be provided to the representative (i.e. transportation, meals, hotel, airfare, etc.)

Speaking Fees

Please note that although the athletic director, coaches and other athletic staff don't personally accept speaking fees, contribution to UB Athletics Blue and White Fund are welcome and always apprecieated.

Have you spoken with any UB Athletics staff member about this appearance request prior to submitting this request?

*If yes, please list the name of the UB Athletics staff member.

* required field

University at Buffalo Athletics

Appearance Request Form

Requester Contact Information

Organization Info

Organization Event Details

Appearance Details