Guest Speaker & High Profile Figure Declaration form

Type of Event

A. Requestor

1. Event Organiser (“signee”): *

First

Last

2. Email *

3. Phone Number: *

4. Club, ISG, Faculty Association or Other (please specify): *

B. Guest Information

1. Speaker (full name): *

First

Last

(a) Proposed Speaker Phone Number *

(b) Proposed Speaker Email Address *

2. Please provide a brief biography of the speaker (education, work, past events): *

3. Is the proposed speaker affiliated to any organizations? *

Yes
No

If YES, please provide details (include organization name, nature of affiliation, short descriptions): *

4. Will the speaker be accompanied by other associates and/or retinue? *

Yes (If YES, please provide names and affiliations in boxes below)
No

(a) Full Name *

(b) Position/Affiliation *

(a) Full Name

(b ) Position/Affiliation

(a) Full Name

(b) Position/Affiliation

C. Event Information

1. Do you have an existing reservation? *

Yes
No (If NO, please provide us with the following details, and we will create a contract for you.)

If YES, please record your Contract #: *

Applicable for those who have already submitted a request for their event and have been sent a tentative contract awaiting confirmation and/or approval.

2. Proposed Title: *

3. Proposed Event Topic(s) / Content: *

4. Event Description: *

5. Proposed Event Date: *

6. Event Start Time: *

7. Event End Time: *

8. Proposed Venue: *

9. Target Audience: *

10. Expected Attendance: *

Links to event on social media

D. Security Details & Risk Assessment

The Students’ Society of McGill University has a responsibility to ensure the safety of its students. Answering “YES” to any of the following questions is unlikely to result in the cancellation of your event; instead, it will help us support your event effectively.

1. Would you reasonably expect the speaker or the topic of discussion to attract any protests? *

Yes
No

2. Has there been disruption at events that have involved the same topic in the past? *

Yes
No

If YES, please provide details: *

3. Has the proposed speaker had issues at other venues in the past? *

Yes
No

If YES, please provide details: *

4. Has the speaker been refused permission to speak at other venues?

Yes
No

If YES, please provide details: *

5. Is there a risk of the speaker’s attendance or subject of discussion (e.g. sex/gender, race, sexual orientation, disability, religion, age etc.) resulting in potentially raising an issue under the SSMU’s Equity policy (see link below this box)? *

Yes
No

If unsure, please review SSMU's Equity Policy here.

Please consider the following:

- The potential for the subject matter or the speaker to cause offence. This may include criticism or negative language relating to an individual or groups based on a protected characteristic (e.g. sex/gender, race, sexual orientation, disability, religion, age etc.) including ‘jokes’ or ‘banter’.

- The potential for the speaker or topic to be found to be “inciting hatred” or causing fear or alarm to attendees to the wider University community.

- You may want to provide copies of relevant policies to the speaker

SSMU Policy and Plan Book

If YES, please provide details: *

6. Are there any identified security threats to the speaker? *

Yes
No

If YES, please provide details: *

7. Does the speaker come with his/her own protective security detail? *

Yes
No

If YES, please provide details *

8. Is the speaker or event likely to attract media interest?

Yes
No

9. Are there any other specific arrangements, requirements or special requests relating to your event?

Yes
No

If YES, please provide details: *

I hereby confirm that I have read, understood and promise to abide by the present Guest Speaker Waiver for External Guests & Visitors and its policies. *

Agree

I confirm that I am of legal age to sign such a binding document. *

Agree