Non-Academic Guest Form

Name *

First Name Last Name

Phone Number *

Area Code Phone Number

E-mail *

Department *

Is your speaker a representative of an organization other than Liberty University? *

Yes No

Are they speaking on behalf of the organization to promote opportunities for current Liberty students to participate in? *

Yes No

Name of company or organization? *

Main Website (Link) *

Does your organization have a formal relationship or affiliation through Liberty University? *

Yes No I don't know

Please share with us about any previous involvement or connection with Liberty University that your company or organization may have, including the names of any faculty or staff with whom you have developed a relationship. *

Please provide a brief history of your company or organization. *

Please outline your vision-statement for your company or organization. *

What countries do you have ongoing work in? (Please add all that apply to student opportunities) - Including US based opportunities. *

What types of service-engagement does your Organization offer? (Select all that Apply) *

What types of opportunities do you offer? (Select all that apply) *

In an effort to maintain safety and security for our students, our Risk Management department has provided ALL countries that we are unable to send students and promote travel opportunities. Per University policy, you are NOT allowed to recruit students to travel with you or promote any opportunities regardless of the nature to these countries. They currently are out of policy and pose a significant threat to their travel safety, educational outcomes and are prohibited by Liberty University. Due to the nature and seriousness of this policy, we ask that you present any questions to our office regarding specific locations within those various countries listed below. Please reach out to us and we will guide you in what is permissible. We want to serve you through this policy. We cannot thank you enough for both blessings our students while also ensuring the safety of the students’ future engagements.

No Travel Permitted or Promoted:

Iran
North Korea
Democratic Republic of Congo
Balkans
Belarus
Ivory Coast
Cuba
Iraq
Liberia
Sudan
Syria
Zimbabwe
Afghanistan
Libya
Somalia
Yemen
Ukraine
Burundi
Haiti
Madagascar
Tunisia
Central African Republic
Chad
Egypt
India (Jammu and Kashmir Provinces)
Israel (Gaza and West Bank Areas)
Lebanon
Mali
Nigeria
Pakistan
Russia (North Caucasus)
Thailand (Pattani, Yala, Sonkhala, Narathiwat Provinces)
Venezuela

Permission must be granted to promote any potential travel location(s) within each of these listed countries:

Algeria
Bahrain
Bangladesh
Bosnia & Herzegovina
Brazil
Burkina Faso
Cambodia, Phnom Penh
Colombia
East Timor
Ecuador (non-Quito)
El Salvador (San Salvador)
Ethiopia (non-Ababa)
Guatemala
Guinea
Honduras
India (Ahmedabad)
Indonesia
Israel (Jerusalem)
Kenya
Kosovo
Kyrgyzstan
Mauritania
Mexico (non-Guadalajara, non-Cancun, non-San Jose del Cabo, non-Veracruz)
Nepal
Niger
Papua New Guinea
Peru (Lima)
Philippines
Saudi Arabia

I have read and confirm that I can abide by this safety policy? *

Yes No I am confused and need more clarification I have a few questions pertaining to this policy

Please share with us why your company or organization is seeking to come on campus? *

Please explain the specific opportunities and locations that you are hoping to share with students and how that will add value to their college experience. *

How long do you intend to promote this opportunity at LU (please provide start and end dates)? *

How long do you intend to remain on campus each day for recruitment (please provide start and end times)? *

Will you need a table/booth set up? *

Yes No

Where would you prefer to have your table set-up for recruiting? (Please list a 2nd and 3rd option for location)? *

What will you be bringing for set-up and/or promotional material? *

Please list the departments that you are seeking to connect and recruit from. *

Is there any other information or questions you have prior to coming on campus? *

Name of Perspective Guest(s) *

Department/Club Name: *

Relevance/Topic Being Discussed *

What is the name of your event? *

Please provide all relevant social media handles for the perspective guest *

Please provide a summary of the event and any activities that will take place. *

Who do you expect the audience to be at the event? *

Examples: Current students, Alumni, Student's in a Specific Club, etc.

How many people do you expect to attend your event? *

Do you have any specific lodging requests for the perspective guest? *

Do you have any transportation requests for the perspective guest? *

If the perspective guest will be driving themselves to the event, please provide the make and model of the vehicle they will be driving. *

Is the perspective guest requesting an honorarium? If so, how much? *

Have you been in contact with Liberty University's marketing department for your event? *

Do you have any food or catering needs for your event? *

Where is the ideal location to host your event? *

What are alternate acceptable locations for your event? *

What is the proposed date for your event? *

Date

All requests must be made at least 30 days in advance of the proposed event date.

Please DO NOT extend an invitation to a guest until you have been notified that they have been approved.

What is an acceptable alternative date for your event? *

Month Day Year

How much time do you expect to need for set up? *

How much time do you expect to need for teardown? *

What time would you like your event to start? *

: Hour Minutes AM/PM Option

What time do you expect your event to end? *

: Hour Minutes AM/PM Option

How much do you have budgeted for this event? *

Do you require catering for this event? *

Yes No

Who will you be using for Catering? *

How many microphones and microphone stands will you need for your event? *

Will you need access to the AV system in the room to hook up a laptop/phone? *

Yes No

Will you need a stage for your event? *

Yes No

What size stage will you need? *

Will you need your event live streamed? *

Yes No

Will you be streaming it to Facebook live? *

Yes No

Would you like it streamed to a room on campus? *

Yes No

Which room would you like for an overflow location? *

Will you need an EP Sound/AV tech for your event? *

Yes No

What time would you like for them to arrive? *

Will you need a soundcheck for your event? *

Yes No

How much time would you like for your soundcheck? *

How many chairs will you need for this event? *

Will you need 8ft rectangular tables? *

Yes No

How many rectangular tables will you need? *

Would you like table clothes? *

Yes No

Will you need round tables? *

Yes No

How many round tables will you need? *

Will you need table clothes? *

Will your guests require any special parking considerations for this event? *

Yes No

How many spaces will you need?

Will you want any special decor for this event? *

Yes No

Will Pastor David, Pastor Josh or President Falwell be attending the event? *

Yes No

Non-Academic Guest Form

Contact Information

Organization Details

Event Information