Name of Event

Date of Event

Start Time

End Time

Location

Contact Person for Event

Contact Phone Number

Contact E-mail

Type of Event (Choose one):

Academic	Alumni
Student Life	Service
Development	Other..

Give a brief summary of the event, as well as listing the type(s) of publicity you desire (e.g. local and/or regional newspaper articles, public service announcements, Impressions article).

NOTE: This form should NOT include requests for paid advertisements. Any advertising requests should be directly presented to the Communications Writer, Megan Cravath. You may contact her via email at mcravath@marywood.edu or by phone at (570) 348-6207.