African American History
Please use this form to request a speaker. If you have any questions, please contact the Speakers Bureau Coordinator at SpeakersBureau@MontgomeryHistory.org or 301-340-2825.
Email Address *
Name of Requesting Group or Venue *
Date of Event *
please provide the date of your event
MM
/
DD
/
YYYY
Time of Event *
Time
:
Name of Contact *
Please provide your name
Phone Number of Contact *
please provide your phone number
Location of Event or Meeting *
Please provide a complete address or-if an online presentation-which platform will be used
Location Phone Number
please provide the number of the venue where the event will take place
Is this a public event? *
Please indicate if this event is open to the public
Anticipated Audience Size
Requested Presentation or Presenter
Please select a presentation from the list below. If you are unsure of which program you want, select other or contact the Speakers Bureau Coordinator at SpeakersBureau@MontgomeryHistory.org or 301-340-2825.
Requested Presentation or Presenter *
Required
Special Requests
Please enter any special requests or needs related to your event here (optional)
If you have any questions, please contact the Speakers Bureau Coordinator at SpeakersBureau@MontgomeryHistory.org or 301-340-2825.
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