CLSJ Speaker Request Form
Thank you for your interest in having a speaker from the Center for Law and Social Justice present at your event.

To request a speaker, please complete and submit the form below. Due to scheduling constraints, CLSJ typically will not be able to accommodate requests for speakers less than 3 weeks or more than 6 months in advance of an event. CLSJ representatives are always excited at the opportunity to speak with members of our community. However, due to our small size, the high volume of requests that we receive and complications related to safety during covid, please note that it may not be possible for us to provide a speaker for every worthwhile event. Thank you for your interest and we appreciate the opportunity to work with you. Please contact the Center for Law and Social Justice at info@clsj.org if you have any questions or need any assistance.
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Email *
Today's Date *
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Name *
Email Address *
Organization/Company Name *
Organization Mission *
Organization or Event Website
Event Name: *
Event Theme *
Event Location *
Event Date *
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Event Start Time *
Time
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Event End Time *
Time
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Confirmation Deadline *
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Type of Speaker Requested *
If a "panel," please list other panelists. If "other," please describe format.
Topic of panel, keynote, presentation, or fireside chat?
Plenary or Breakout Session?
Clear selection
Length of time for speaker's presentation? *
Event Co-Sponsors
If this is not a first time event, please provide a list of previous speakers. If this is a first time event, simply state "n/a". *
Has someone from CLSJ ever spoken at your event before? *
If yes, please indicate which CLSJ speakers have spoken at your event before:
Conference Agenda: If there is a website with your agenda posted, please provide the URL. Otherwise, please paste your agenda in the space provided *
Please provide the names of confirmed speakers. *
Audience Demographics: Please provide a short description of anticipated audience size and general demographics.
Requested CLSJ Speaker: Please provide the name of the speaker you wish to present at your event. *
Please describe the security precautions you have in place for this event. *
If the CLSJ representative of your choice is not available, would you accept an alternative speaker? *
Are press invited? *
Will the presentation be recorded? *
If the presentation will be recorded, will you provide CLSJ with a copy of the recording?
Clear selection
Will the presentation be live streamed or shared via social media? *
If the presentation will be live streamed or shared via social media, please list the social media handles where the presentation will be posted.
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