International Representative Visit Request

International board members and staff are in great demand for appearances at club and region functions; frequently, several invitations are received for the same event. Therefore, we must coordinate travel through the Civitan World Headquarters to avoid costly duplication of resources

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Name of Staff/ Board Member you are requesting

Name of Person requesting speaker

Club or Region requesting speaker

Please explain the purpose of this visit

Requested Arrival Date

Requested Departure Date

Is the spouse of the individual invited?

Yes

Location of Event (Hotel/Meeting Space with full address)

Will the club/region cover travel cost to and from the meeting site?

Yes

Will the club/region pay for hotel accomodations, registrations fees, and any special meals or events for the speaker?

Yes

Contact Person for Requested Speaker

First Last

Phone

Details of specific duties you wish the speaker to preform

Dress Code for the event

Detailed itinerary for requested speaker

Any additional information or comments.

International Representative Visit Request

International Representative Visit Request

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