Speaker Request Form
Please fill out this form to request an Innocence Project staff or exoneree speaker for your event or email us: speakers@innocenceproject.org.
Name and website of group or institution: *
Your answer
Name, title and affiliation of representative making the request: *
Your answer
Phone, email address and mailing address of representative making the request: *
Your answer
Location of speaking engagement: *
Your answer
Date and time of speaking engagement (if you’re considering a number of possible dates and haven’t chosen one yet, please include all possible dates): *
Your answer
Format and length of speaking engagement (for example, indicate whether it’s a single­ speaker format or a panel, and indicate if you have a preference for how much of the time will be spent on presentation and how much on questions and answers): *
Your answer
What is the size of the audience? Who is the audience? *
Your answer
Can you provide an honorarium? If so, how much? Do you cover travel expenses? *
Your answer
What kind of speaker would you like? *
Submit
Never submit passwords through Google Forms.
This form was created inside of Innocence Project, Inc. Report Abuse