OP Nonprofit Speaker Request 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 Video Submission 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. Δ
