Book a Speaker Form

Requesting Organization

Name of Your Organization *

First Name *

Last Name *

Email Address *

Phone Number *

Date *

Location *

Purpose of Event *

Goal for WE ARE VB Participation: *Community AwarenessFundraisingOutreach to School ProfessionalsOutreach/Support Directly for Students

Please Explain Your Goals/Expectations for This Event *

Arrival Time at Event *

Duration of Speaking Time *

Focus of the Speaker’s Comments *

Please List Any Multimedia/AV Expectations for Our Speaker *

Logistical expectations *WE ARE VB Banner6 foot table(s)WE ARE VB HandoutsAdditional WE ARE VB Manpower

Expected WE ARE VB Promotion *FacebookInstagramConstant Contact/Email

If not listed above, please enter here *

Please Provide Any Other Relevant Information *