CSA - Online Invitation Form

Please upload a copy of your program, agenda or itinerary, or any other supporting document before completing the rest of the form.

B. About Your Organization

Note: If you have been hired by another organization to plan this event, provide the information about your company AND the host organization.

* Fields preceded by a red star are mandatory.

Host Organization

* Name:

* Description of the organization:

* Is your organization a commercial (for-profit) entity?

* Number of members or employees:

* Address with number and street name:

* City:

* Province:

* Postal code: (ex: J3Y8Y9)

* Contact person managing the event:

Title or role of the contact person:

* Telephone: (ex: 450-123-4567)

Fax: (ex: 450-123-4567)

Cellular: (ex: 450-123-4567)

* E-mail address:
(important: indicate one address only)

Retype to confirm e-mail address:

C. Description of the Event

Your Event

Presentation by the Speaker

Date of event or conference:

* Date of the presentation:

Is this date flexible?

* Is this date flexible?

Time and duration:

* Time and duration:

* Date by which you require an answer:

Please detail:

Description of the Event

* Name or theme of the event:

* Is your event part of a fundraising campaign?

* Venue: (hotel, meeting room,
gymnasium, etc.)

* Full address of the event:

* Description and objectives of the event:

* Is there an exhibition component
planned during your event?

Date of the exhibition:
(if different from the date of the event)

Would you like the speaker to talk about a specific topic?

First choice:

Second choice:

Other:

If you are applying on behalf of a school
or other youth group, please indicate
the ages: 6-8 years old
9-11 years old
12-14 years old
15-18 years old

Number of persons expected to attend
the event:

* Number of persons expected to attend the speaker's presentation:

* Preferred language:

* What audiovisual equipment
can you provide?

Tip: Make sure that the presentation room
will be dark enough for projecting images effectively. Computer
Multimedia projector
Audio connection into a sound system
Large screen
Microphone (preferably a lapel microphone)

* Will the media be invited to the event?

If not, can the CSA invite media?

How will the event be publicized?
(by invitation, ad in newspaper, posters, etc.)

D. About the Speaker

* Type of spokesperson requested:

If other:

Name of suggested speaker (if known):

If you wish to invite an astronaut, which one would you like to invite?

Should your first choices not be available, would you accept another astronaut?

Finally, should an astronaut not be available, would you accept another speaker?

* Do you have videoconferencing capability?

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Table of Contents

Online Invitation Form

A. First, upload all relevant documents

B. About Your Organization

C. Description of the Event

D. About the Speaker

E. Remarks

F. Submit the form