Public Expression Form

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Public Expression Form

Students or employees wishing to engage in public expression on Messiah’s campus or university-owned property must first apply to the Office of the Dean of Students using the below online form at least five (5) business days prior to the requested date of activity. (Business hours are between the hours of 8 a.m. and 5 p.m., Monday through Friday.) The dean of students has two (2) business days in which to act on a request and communicate a decision to the person or organization making the request.

NOTE: Before submitting the below form, please read the Messiah University Public Expression Policy.

1. Organizer's name Required

2. Organizer's email Required

3. Organizer's cell phone Required

4. Are there any additional event organizers? Required

Yes No Help: Public expression organizers must be current Messiah students or employees.

5. If yes, please list their name(s), email(s), and cell phone number(s).

6. Proposed date Required

Help: Public expression events are scheduled M-F during the academic year.

7. Proposed start and end time Required

Help: Public expression events are scheduled during the hours 8 a.m.-5 p.m. with a 2-3 hour max duration.

8. Is this public expression sponsored by a Messiah University organization/group? Required

Yes No

9. If yes, what organization/group? Required

Help: If not a group, please enter N/A.

10. How many people are expected to be a part of this event? Required

11. Purpose for Public Expression: Required

12. Please include details of the proposed activities for the public expression event: Required

13. Are you considering inviting media to this event? Required

Yes No

14. If yes, proposed objective/goals for media coverage:

Help: If yes, University protocols require that you must first consult and work with the Office of Marketing and Communications in advance.

15. Location requested Required

Help: Public Expression activities are permitted in the following locations: Larsen Student Union Patio or Larsen Student Union common area, Eisenhower Campus Center Commons, Brick Courtyard by Kline, Jordan, and Frey.

16. I have read and understand the University's policy regarding public expression in this document and if my public expression activity is approved, I/my organization/other organizers agree to abide by those guidelines. My full typed name below represents my electronic signature: Signed by (primary organizer): Required

17. Signature date: Required