Independent Citizen Review Board

vbicrb@vbgov.com

ICRB Speaker/Event Request

Thank you for your interest in having a representative from the Independent Citizen Review Board (ICRB) attend your event. Please use this form to request a speaking engagement or event appearance by the ICRB.

While the ICRB will make every effort to accommodate requests, it may not be possible to accept all invitations. Please submit a request at least 30 days prior to the event to allow full consideration.

Contact Information

Phone Number

Event Information

Name of Event

Location of Event

Contact Phone Number for Day of Event

Event Date

Start Time

End Time

In the event that the ICRB representative cannot stay for your entire event please indicate the specific time frame during the event that you would like to have them present.

Tell us about the event. What is it for/what is the purpose?

What is the agenda (include key participants and other speakers)?

Indoor/Outdoor Events

Indoor

OUtdoor

Is this event open to the public or is it a private event?

Open to Public

Private

Number of expected attendees?

Name of the sponsoring organization?

Please provide information about parking at the event location.

Details of Request

If requesting speaker, how many minutes are you allotting for the remarks/presentation?

Upon Arrival at Venue tell us what the ICRB representative should do upon arrival.

Go to a specific room

Will be greeted/escorted

Must register with host

Format of Room

Guests will be seated in rows of chairs

Guests will be seated at tables

Speakers will be standing on stage

Speakers will be seated on stage

Speakers will have lectern/podium

Speakers will have stationary microphone

Speakers will have lapel/lavaliere microphone

Speakers will have hand-held microphone

Other details about the event the ICRB representative should know: