Alpha Kappa Alpha Sorority, Incorporated® International Region

Regional Director Engagement Request Form

Name *

Name Of Requester *

Chapter *

Chapter Name (Outside the Region) *

Cluster *

Phone Number *

Email Address *

Role Request of Regional Director *

Engagement Type *

Event Type *

Event Date * +

Event Start Time *

Event Name *

Event Theme *

Event Description *

Tentative Agenda for the Event *

Estimated Number of Attendees *

Guests in Attendance (check all that apply) *

Alpha Kappa Alpha Sorority members only

Guests

Open to the Public

List any special guests and dignitaries including their official titles (separate with semi-colons). Enter 'n/a' if not applicable. *

Please include any additional flyers or material that provides more information about the engagement.