OP Nonprofit Speaker Request Δ Event Type(Required) Kick off Team meeting Training Other State Department(Required)Department Contact InfoCampaign Liaison Name(Required) First Last Campaign Liaison Email(Required) Enter Email Confirm Email Campaign Liaison Phone(Required)Site Contact Person Name*If different from Campaign Liaison* First Last Site Contact Person Email Enter Email Confirm Email Site Contact Person PhoneEvent InformationDate of Event(Required) MM slash DD slash YYYY Start Time(Required) Hours : Minutes AM PM AM/PM End Time(Required) Hours : Minutes AM PM AM/PM Event Location*If your event will be in-person, please complete this section*Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Event DetailsAudience Size(Required)Preferred Speaker Representation(Required) In-Person Virtual Presentation Presentation Length(Required) 1 – 3 minutes 3 – 4 minutes 5 – 10 minutes 10 – 15 minutes Other Select causes you are interested in hearing about:(Required) Animals Arts & Culture Civil Rights & Advocacy Community Improvement Education Environment Health Human Services Senior Citizens Other comments or instructions:Please note: Nonprofits will be available for in person and virtual meetings, and can provide digital items; photos, social media platforms, and other resources.
