Coach & Administrator Speaking, Appearance & Video Request Form

Coach & Administrator Speaking, Appearance & Video Request Form

University of Michigan Athletics receives numerous speaking requests on behalf of our coaches and athletic administrators. The NCAA and U-M Athletics strictly regulate the manner in which coaches and staff may participate in these activities. In an effort to best process your request and to assist us with the internal approval process, please submit your speaking request using the form below. Requests must comply with the guidelines listed on our website. Please understand that submission of a request, even if all guidelines are met, does not guarantee that the request will be fulfilled.
Organization name*
Organization address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Is this request affiliated with a University of Michigan school, college or unit?
If so, please indicate the school, college, or unit
Name of requester*

First NameLast Name
Title/relationship to organization *
What is your relationship to the organization for which you are submitting the request
Requester email address*
example@example.com
Requester phone number*
Select your first choice speaker*
Please specify the administrator and/or staff member
Select your second choice speaker, if applicable
Select your third choice speaker, if applicable
Type of Request*

Speaking Request (Coach/admin being asked to speak at an event)Appearance Request (Coach/admin being asked to attend event, but not speak)Video/virtual Request (Coach/admin being asked to film a video message, participate in a video call and/or participate on live social media)Fundraising Ambassador Request (Coach/admin is being asked to support the fundraising efforts of a non-profit organization)
What is the video format?*

Prerecorded video messageLive appearance in a video conference call (example: Zoom call)Live apperance in a social media video (example: Facebook Live, Instagram Live, etc.)Other
Event title*
Event date & time*

MonthDayYear
Date
Hour MinutesAM/PM Option
Event location (required for speaking & appearance requests)
City, State
Number of guests*
Age range of attendees*
Age range of audience (check all that apply)*

Elementary school (Kindergarten - 5th grade)Middle school (6th - 8th grade)High school (9th - 12th grade)Adults (age 18+)
Event sponsor (if there are none, please put N/A)*
Provide a thorough description of the request*
Is there any fundraising activity taking place at the event or part of this request? *
If so, please provide a thorough description.
Will any advertising be done for the event?*
If so, please provide a thorough description.
Comments
Please provide any additional information you feel is relevant to your request
Please provide any event fliers, marketing materials, etc. related to your request.

Cancelof
Has a member of the Athletic Department staff referred you to this for to submit a request?*
If so, please indicate who.
Should be Empty: