Request a TAKE ON HATE Speaker/Representative
Please fill out this form to request a TAKE ON HATE representative at your event! Requests should be submitted at least two weeks in advance.
Email address *
Organization Name *
Your answer
Date of Event *
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Time of Event *
Time
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Do you require a speaker? *
What is the goal of the event? *
Your answer
Please list any partner organizations. *
Your answer
Please provide additional details related to your request. *
Your answer
*Please submit a new response for any additional requests.
A copy of your responses will be emailed to the address you provided.
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