Guest Speaker Request Form

Requesting Organization

Name of Your Organization:

Name of Contact Person:

Phone:

Email:

Event Details

Date of Event:

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:

Speaker Expectations

Arrival Time at Event:

Duration of Speaking Time:

Focus of the Speaker’s Comments:

Please List Any Multimedia/AV Expectations for Our Speaker:

Promotion or Logistical Expectations/Requirements

Logistical expectations:
WE ARE VB Banner6 foot table(s)WE ARE VB HandoutsAdditional WE ARE VB Manpower
Expected WE ARE VB Promotion:
FacebookWebsiteInstagramTwitterConstant Contact/Email
If not listed above, please enter here:

Please Provide Any Other Relevant Information: